The NSA IDR process, whether state or federal, is a form of arbitration. It introduces a third-party entity to the negotiation situation to determine what a medical practice is owed based on the presentation of evidence. The process is relatively straightforward but requires careful documentation to maximize the opportunity. That’s where we come in. Our specialists handle IDR for providers regularly, and our expertise means our clients can focus on other aspects of their business. The IDR process is relatively straightforward. It’s a 30-day period of open negotiation followed by filing for IDR if no resolution occurs. Both parties present a certified third party with documentation and an offer before the third-party picks which party presents a better case. The decision is considered binding, and parties have 30 days to comply with the third party’s decision. The process is impartial, but that doesn’t mean it is automatic.
IDR does have some mandatory non-refundable fees associated with it. These administrative fees are part of the process and paid before IDR begins to help prevent abuse of the system. Additionally, IDR collections may be necessary. Generally, it’s in the interest of both parties to comply with the IDR decision promptly. However, in some cases, collections are essential to ensure the practice receives the revenue it’s due. This process can become complex quickly, and managing it can affect how a practice’s RCM looks.
Under Independent Dispute Resolution No Surprises Act, a clear process exists for practices to be used with payors. However, this is sometimes insufficient to address payor tactics as they relate to independent practices. Since we focus on provider services Independent Dispute Resolution, we understand how payors minimize their own risk in the process and how to negotiate the tactics involved. We know how to leverage the IDR system without creating additional burdens on practices and avoiding payor tactics designed to minimize their losses. Our experience and expertise can transform how this process works for practices while improving the chances of a favorable outcome. We help practices keep more of their revenue, regardless of what payors do.