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    We do the hard work of healthcare reimbursement for doctors.

    MedResolutions runs the dispute, appeal, and recovery work most practices don't have the time, data, or appetite to handle. We take underpaid out-of-network claims and turn them into collected revenue.

    The healthcare crisis

    Practices are being asked to do more with less leverage.

    Burnout from paperwork

    Administrative work and after-hours EHR time keep pulling doctors away from patients, families, and recovery.

    Source: AMA, 2024

    Increasing denials

    Providers report more claims are being denied, forcing practices to spend scarce time reworking payment that should have been straightforward.

    Source: Experian Health, 2024

    Decreasing independence

    Private practice keeps getting harder to sustain as payment pressure, regulation, and administrative burden push physicians into larger systems.

    Source: AMA, 2025

    Staffing shortages

    Medical groups are still fighting for the people who keep practices moving, especially clinical and front-office support roles.

    Source: MGMA, 2024

    Why MedRes exists

    Healthcare reimbursement should be simple. That is not how the system works.

    01

    The payment was wrong. Now what?

    When a claim is underpaid, the question is rarely just whether the payer got it wrong. The question is whether anyone has the time, evidence, and procedural knowledge to do something about it.

    02

    Payers have process leverage

    Payers have specialized teams, historical pricing data, automated workflows, and time on their side. Independent practices usually have a billing team already stretched by daily collections work.

    03

    Recoverable claims get written off

    Many underpaid out-of-network claims are not unwinnable. They are operationally inconvenient. Without a dedicated workflow, the write-off becomes the path of least resistance.

    What changed

    Out-of-network recovery is no longer just billing follow-up.

    The No Surprises Act changed the landscape. For eligible claims, IDR created a path to challenge underpayment, but that path is procedural. It depends on plan type, service category, deadlines, payer behavior, evidence, filing rules, and the economics of pursuing each matter.

    In other cases, IDR is not the right route at all. The answer may be appeal strategy, payer escalation, contract analysis, or a decision not to pursue.

    What we do

    Claim review before commitment

    We start with a claim sample, screen for recovery potential, identify the likely route, and explain what is worth pursuing before the practice commits operational energy.

    Execution for the hard claims

    We do not replace a billing department. We handle the matters that need extra judgment, evidence, routing, deadline management, and persistence.

    Recovery paths, not one-size-fits-all advice

    Some claims may fit IDR. Others may need appeals, payer escalation, contract analysis, or a decision not to pursue. The route matters.

    Operating principles

    The work has to be disciplined before it is aggressive.

    We do not make every claim a fight. We identify which claims are worth fighting for, then follow the work through.

    01Screen before pursuing
    02Prove the underpayment
    03Route claims carefully
    04Execute through payment
    05Protect sensitive claim data

    Start with a claim sample.

    A good engagement starts with a direct answer: what is recoverable, what route applies, and whether the economics justify the work.

    01
    Claim sample review
    02
    Eligibility and plan screen
    03
    Payer and payment analysis
    04
    Negotiation, IDR, appeal, or escalation path
    05
    Payment follow-up and tracking
    The future

    MedRes is building the operating layer for out-of-network recovery.

    Today, that means helping practices identify and pursue underpaid claims through negotiation, IDR, appeals, payer escalation, and payment follow-up. Over time, it means better triage, better payer intelligence, better evidence packages, better routing decisions, and better tracking from underpayment to collection.

    Claim and reimbursement data deserve disciplined workflows. MedRes is built around secure handling, minimum necessary access, and business associate agreements where required.

    Talk through a payer issue