CollectionPro, a national provider of out-of-network claims recovery and Independent Dispute Resolution arbitration support, has introduced a free evaluation service designed to help healthcare providers determine which out-of-network claims may be eligible for recovery through federal and state arbitration processes. This service comes at a critical time as healthcare providers continue to navigate the complex reimbursement landscape created by the No Surprises Act, which took effect in 2022 and significantly altered out-of-network reimbursement workflows by prohibiting balance billing and shifting greater financial responsibility to payers.
The No Surprises Act has created both opportunities and challenges for healthcare providers, with many facing increased underpayments and complex administrative requirements that make it difficult to determine which claims qualify for IDR escalation. CollectionPro's new evaluation service offers a no-cost review of out-of-network claims to help providers identify several key categories: 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.
Maverick Johnson, spokesperson for CollectionPro, explained that many providers avoid pursuing arbitration due to uncertainty about which claims qualify. The free evaluation service aims to remove this uncertainty by providing a clear assessment of eligible out-of-network claims, giving providers a starting point for pursuing appropriate recovery pathways. This service is particularly valuable given CollectionPro's extensive experience in the field, 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. CollectionPro's team also reviews aging out-of-network claims, including those up to three years old, to check their eligibility for reappeal and fresh arbitration. This comprehensive approach ensures that providers don't miss potential recovery opportunities for claims they may have previously written off as uncollectible.
For providers who proceed with full arbitration services, CollectionPro typically advances the entire administration fee of $115 and arbitration fees of up to $1200, eliminating financial risk for healthcare providers. The company operates on a success-based fee model, charging as low as 10% only after reimbursement recovery, with no subscription costs, hidden fees, or binding contracts. This risk-free approach has made the service particularly attractive to providers managing out-of-network claims with Medicare, Medicaid, or commercial payers.
The free evaluation is available for a limited time to all specialties burdened with out-of-network claims, including air ambulance, neurosurgery, anesthesiology, ambulatory surgical, orthopedics, plastic surgery, neonatology, emergency medicine, pathology, critical care providers, cardiology, nephrology, radiology, obstetrics and gynecology, and other providers. Healthcare providers interested in the service can request a free evaluation through the company's website at https://collectionpro.com/free-evaluation.
