CollectionPro, a national provider of out-of-network claims recovery and Independent Dispute Resolution arbitration support, has launched a free evaluation service to help healthcare providers determine which out-of-network claims may be eligible for recovery through federal and state arbitration processes. The service comes as healthcare providers continue to navigate the complexities of the No Surprises Act, which took effect in 2022 and significantly changed out-of-network reimbursement workflows by prohibiting balance billing and shifting greater financial responsibility to payers.
The free evaluation offers a no-cost review of out-of-network claims to help providers identify several key categories of potentially recoverable claims. These include 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 resubmitted for reconsideration. The evaluation provides a clear assessment of eligible out-of-network claims, giving providers a starting point for pursuing appropriate recovery pathways.
Many providers struggle to determine which claims qualify for IDR escalation amid increased underpayments and complex administrative requirements. CollectionPro's spokesperson Maverick Johnson noted that uncertainty often prevents providers from pursuing arbitration altogether. The free evaluation aims to remove that uncertainty by helping providers identify whether legitimate recovery pathways exist for their specific claims.
CollectionPro has substantial experience in this area, having supported more than 10,000 IDR filings under the No Surprises Act with a reported 92% success rate across multiple specialties. The company's team reviews aging out-of-network claims, including those up to three years old, to check their eligibility for reappeal and fresh arbitration. Their expertise spans emergency medicine, anesthesiology, radiology, pathology, dialysis, surgical subspecialties and air ambulance services.
The company typically offers full arbitration services to healthcare providers by advancing the entire administration and arbitration fees, leaving providers with no financial risk. Providers pay a success-based fee, as low as 10%, only after reimbursement recovery occurs. This model has been described as a no-brainer deal by providers who have used the service, with no subscription costs, hidden fees, or binding contracts required.
The free evaluation service is available for a limited time and applies to all specialties burdened with out-of-network claims. This includes 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 can request the free evaluation through the company's website at https://collectionpro.com/free-evaluation.
