IDR Services

We help organizations identify eligible claims, preserve deadlines, develop evidence, and push underpaid out-of-network matters through the right recovery path.

At MedResolutions, we start by reviewing your out-of-network claims to identify which are eligible for federal arbitration under the No Surprises Act. From there, we manage every step of the dispute — from the 30-day open negotiation window through final offer arbitration — ensuring nothing slips through the cracks.

Data-Driven Case Building

We leverage Transparency in Coverage (TiC) data to build strong, evidence-based arguments for each claim. Our cases are built on:

• Market Benchmarks: Real negotiated rates from comparable providers in your region for the same procedure codes.
• Scarcity by Specialty: Demonstrating limited provider availability in a given market to justify higher reimbursement.
• Insurer Market Share: Using payer dominance data to contextualize rate disparities and support fair payment arguments.
• Historical Payments: Leveraging prior payment patterns to establish a baseline and identify systematic underpayment.
• Medicare Multipliers & Peer Benchmarks: Cross-referencing Medicare rates and peer reimbursements to anchor final offer submissions.

Complete Process Coverage

Every claim follows a precise path — and one missed step or improperly formatted submission can jeopardize an entire case. We ensure each dispute is routed through the correct process, whether state or federal, and handle all required filings, deadlines, and follow-ups on your behalf.

We manage disputes across all states and federal jurisdictions, keeping you informed throughout while your team stays focused on patient care. With our contingency-based model, you only pay when we win.