The implementation of the No Surprises Act in 2022 fundamentally altered the landscape of out-of-network healthcare billing, prohibiting balance billing to patients while shifting greater financial responsibility to insurance payers. This regulatory change has created significant challenges for healthcare providers who now face increased underpayments and complex administrative requirements when dealing with out-of-network claims. Many providers struggle to determine which claims qualify for Independent Dispute Resolution escalation, leaving substantial reimbursement amounts uncollected.
CollectionPro, a national provider of out-of-network claims recovery and IDR arbitration support, has launched a Free Evaluation service designed to address this critical gap in provider knowledge. The service offers healthcare providers a no-cost review of their out-of-network claims to identify which may be eligible for recovery through federal and state arbitration processes. This evaluation specifically helps providers identify claims potentially eligible for IDR under the No Surprises Act, claims that may qualify for arbitration under applicable state balance-billing laws, claims still within required filing and appeal windows, and claims that may be reopened, corrected or re-submitted for reconsideration.
The importance of this service lies in addressing the widespread uncertainty that prevents many providers from pursuing legitimate reimbursement claims. Many providers simply don't pursue arbitration because they lack certainty about which claims qualify, according to Maverick Johnson, spokesperson for CollectionPro. The Free Evaluation removes that uncertainty and helps providers identify whether legitimate recovery pathways exist for their outstanding claims.
CollectionPro brings substantial experience to this initiative, having supported more than 10,000 IDR filings under the No Surprises Act with a reported 92% success rate across multiple medical specialties. The company's expertise spans emergency medicine, anesthesiology, radiology, pathology, dialysis, surgical subspecialties and air ambulance services. Their team also reviews aging out-of-network claims, including those up to three years old, to check eligibility for reappeal and fresh arbitration.
The financial implications for healthcare providers are significant. CollectionPro typically offers full arbitration services by advancing the entire administration fee of $115 and arbitration fees up to $1200, leaving providers with no financial risk. The company operates on a success-based fee model, charging as low as 10% only after reimbursement recovery occurs, with no subscription costs, hidden fees, or binding contracts.
The Free Evaluation service is available for a limited period and applies to all specialties burdened with out-of-network claims, including air ambulance services, neurosurgery, anesthesiology, ambulatory surgical centers, orthopedics, plastic surgery, neonatology, emergency medicine, pathology, critical care providers, cardiology, nephrology, radiology, obstetrics and gynecology, and other providers managing out-of-network claims with Medicare, Medicaid or commercial payers. Healthcare providers may request a Free Evaluation at https://collectionpro.com/free-evaluation.
