IDR Recovery — Insight Medical Consulting
IDR Service Independent Dispute Resolution

IDR Recovery Services for Independent Medical Practices

Recover the underpaid claims already sitting in your out-of-network data, through a federal process that finally gives independent providers a stronger voice against payer short pays.

88%
Provider win rate in IDR disputes nationally
CMS data analysis, 2025
87%
Awards landing above the insurer's QPA benchmark
Industry-reported aggregates
$15
Filing fee per dispute after May 2026 federal rule
Down from $115 — an 85% reduction

Large systems already do this

PE-backed billing firms account for roughly 44% of all IDR filings nationally. Independent practices have been leaving the same recoverable revenue on the table year after year.

The revenue is invisible

Underpayments hide inside claims that already show as paid. Without a system watching for them, they never surface as a denial and never get worked.

1

Claim eligibility review

We screen your out-of-network claims against current IDR eligibility rules, including specialty-specific qualifications for anesthesia, emergency medicine, radiology, pathology, neonatology, hospitalists, intensivists, and assistant surgeons. Roughly one in five disputes filed nationally is ineligible. We screen first so every dispute we file has a real chance of winning.

2

Building the evidence-based offer

IDR outcomes depend on the strength of the number each side submits. We benchmark your claims and build an evidence-based offer designed to win under arbitration standards. Winning awards are often three to four times the comparable in-network rate.

3

Filing, negotiation, and arbitration

We manage every deadline from the 30-business-day open negotiation window through formal dispute filing and arbitration submission. Filing windows are unforgiving since the May 2026 rule tightened eligibility requirements, batch caps, and deadlines. Nothing is lost to a missed window.

4

Recovery delivered

Award collected. Your practice sees the revenue without absorbing the administrative burden or spending a dollar until we collect.

Eligibility screening

We only pursue claims that are truly out-of-network. We never create or manufacture network status.

Evidence-based offer development

The strongest possible number for each dispute, benchmarked against market data.

Filing and deadline management

Every submission, negotiation window, and arbitration deadline handled on your behalf.

Specialty-specific strategy

Tailored review for anesthesia, emergency medicine, radiology, pathology, neonatology, and more.

Contingency-based fee

You only pay if we collect. No upfront cost, no new clinical volume, no operational lift.

End-to-end management

Your team never has to become dispute-resolution experts. We run the full process.

Independent out-of-network providers treating patients at in-network facilities on commercial or employer ERISA plans.

Anesthesia Emergency medicine Radiology Pathology Neonatology Hospitalists Intensivists Assistant surgeons Air ambulance

Not a fit

Medicare, Medicaid, TRICARE, and government payer claims are not IDR-eligible. Groups already fully in-network or office-based specialties patients choose in advance also do not qualify.

"We only pursue claims that are genuinely out-of-network. We never create or manufacture network status — which protects your practice from regulatory and headline risk."

Recover what you are already owed

You already provided the care. Let us look at your out-of-network claims data and show you what is sitting there before you spend a dollar chasing it.

Figures reflect industry-reported aggregates from CMS data analyses. Actual outcomes vary by specialty, payer, geography, and claim, and are not a guarantee of results.