Independent Dispute Resolution Specialists
Insurer underpayments don’t have to impact your financial health. Agility RCM has a proven track record of helping out-of-network practices significantly increase revenue through the federal IDR process.
Get Paid Fairly for Out-of-Network Services
At Agility RCM, we specialize in the federal independent dispute resolution (IDR) process. Our experts understand the complexities of the regulations and the rapid timelines, ensuring your out-of-network claim disputes are submitted into the IDR process portal right the first time. This helps you maximize reimbursements and get paid for services more quickly.
about idr
What is the Federal Independent Dispute Resolution (IDR) Process?
The federal IDR process was established by the No Surprises Act. It gives out-of-network healthcare providers a last-resort option to challenge insurer underpayments for services rendered at an in-network facility. The process involves submitting an application to a certified IDR entity with supporting evidence on why additional payment is justified.
Once the federal IDR process is initiated, the healthcare provider and insurer make final offers.The IDR entity then determines which offer is fair based on criteria set by Congress and federal regulators. Through the IDR process, Agility has helped practices win additional payments that are 500% to 2500% greater than the initial commercial insurer payments.
Why Choose Agility for Federal IDR Services?
Highly Specialized Expertise
Our team has mastered the nuances and complexities of the IDR process, ensuring your claims are accurate, well-supported, and timely.
Proven Results
We’ve submitted hundreds of claims to the federal IDR process since the portal opened in 2022, resulting in significantly higher payments for our clients.
Streamlined Processes
With a user-friendly online portal and specialists who handle all aspects of the IDR process, working with us saves you time, effort, and headaches.
How to Start Submitting Underpaid Claims to Federal IDR
Consult With Our Specialists
During a short conference call, our IDR specialists will evaluate your underpaid claims and determine their eligibility for the IDR process.
Initiate the Process
After you review and sign our collection services agreement, we’ll begin onboarding and get you set up on our secure online portal.
Submit Claims
Once you submit your claim information and supporting documentation through the portal, we’ll handle the rest, ensuring your IDR application is strong, timely, and accurate.
FAQs About the Federal IDR Process
Out-of-network practices that provide services at in-network facilities can submit claims to the IDR process.
Claims for services provided on or after January 1, 2022 may be eligible for the federal IDR process, depending on:
- The type of health plan the claim is submitted to (i.e., self-funded vs. fully-funded)
- The state in which services were provided. Certain states have state IDR processes that disqualify some claims from being submitted to the federal IDR process.
- How much time has passed since an insurer has made an initial payment of the claim. The federal IDR process is time-sensitive. After a set timeframe, claims may no longer be eligible for federal IDR.
Currently, it takes about four to six months for a payment determination to be made after a federal IDR process is triggered. However, various factors can influence this timeline, including how backlogged a certified IDR entity is.
don’t wait
Maximize Your Revenue Today
Don’t leave money on the table. Contact Agility RCM to start the federal IDR process and secure the payments your practice deserves. IDR applications are time-sensitive, so book a complimentary consultation today!
