When you hear IDR, it may bring to mind a long process that you hope you get paid at the end of for medical services you’ve already completed. This frustration is normal for practices. Fortunately, it doesn’t have to be with No Surprise Billing (NSB).
The IDR process is part of the No Surprise Act. In 2022, the IDR portal launched along with specific guidelines for filing complaints. Your practice has probably interacted with this system before, but you may not have found it helpful for your needs.
Open Negotiation: - The open negotiation period is 30 days, starting from when a notice of dispute is received. During this period, your practice tries to negotiate with the payer directly. If your practice does this regularly, you may find that many payers are committed to undervaluing your services as a medical professional.
Choose an Entity: - The NSA IDR process uses certified third-party entities to make arbitration decisions. While you can choose from the list, the choice is a mutual one between your practice and the payer. This can cause a significant amount of tension, and that’s before the mandatory IDR fees.
Submit Documentation and Offers: - This step typically requires extensive documentation from both parties and comprehensive offers. Your electronic health records are helpful at this stage of the federal or state NSA IDR process but will likely require additional work for presentation.
The Entity Decides: - The IDR entity makes a final decision if one has not been reached. Once the decision is made, it must go into effect within 30 days. The only exception is if your practice and the payer manage to reach an agreement before the decision is finalized.
Each independent dispute resolution service process takes time and resources from your practice. These resources could be used to serve more patients, address billing concerns, or any number of other tasks. In effect, IDR uses resources you could better use elsewhere.
NSB can not only streamline an individual IDR but also address IDR collections as a whole. We have the experience to aggressively leverage the IDR process and ensure that your practice retains more revenue for your services.