Independent Dispute Resolution (IDR)
End-to-end IDR under the No Surprises Act, managed by a team with extensive payer-side experience.
INDEPENDENT DISPUTE RESOLUTION
Your trusted partner for IDR
Navigating the Independent Dispute Resolution process is complex and deadline-driven. BillWell provides end-to-end support to help healthcare providers resolve payment disputes efficiently and in full compliance with applicable federal and state requirements. We manage every phase of claims subject to the No Surprises Act, so you can focus on patient care. And because billing and IDR live under one roof, the billing-to-dispute handoff is seamless: no lost documentation, no missed deadlines, no claims falling through the cracks.
OUR PROCESS
How the process works
Eligibility Assessment
We evaluate whether each case qualifies for IDR: billed charges, services rendered, dates and place of service, geography, service codes, and applicable plans.
Pre-IDR Negotiation
We leverage payer-side expertise to negotiate competitive rates directly with payers, aiming to settle before arbitration.
Dispute Initiation
When negotiation fails, we submit the Notice of IDR Initiation with complete, accurate documentation.
Data Preparation
We compile and present the data that supports your position for fair reimbursement.
Arbitrator Selection
We guide certified IDR entity selection to ensure the arbitrator is qualified for your dispute.
Offer Submission
We craft a compelling payment offer backed by data and evidence to maximize a favorable determination.
Resolution & Follow-Up
After the decision, we implement the resolution, ensure compliance with the determination, and prepare for future disputes.
Why disputes get dismissed, and why ours don’t
A large share of industry IDR filings are dismissed on eligibility technicalities. BillWell claims are scrubbed before billing, re-verified for IDR eligibility before filing, and prepared by a team that stays current with evolving regulatory requirements.
FAQ
Frequently asked questions
What claims qualify for the IDR process?
Qualifying items and services include emergency care, out-of-network providers rendering services at in-network facilities, and air ambulance, with dates of service on or after January 1, 2022, meeting eligible place-of-service codes and specialties.
How long does the process take?
Generally 60–90 days. Some cases resolve faster; others can take longer depending on volume and the certified IDR entity.
What documentation is needed to get started?
Dates and locations of service, services rendered, claim numbers, EOBs/EOPs, provider credentialing information, facility agreements, prior network participation, and a practice administrative contact.
What level of service can I expect?
Proactive updates at every stage, expertise in evolving IDR regulations, a dedicated support team with quick response times, and consistent follow-up after significant milestones.
How much do IDR services cost?
Our IDR services are contingency-based: we only get paid when you do. There are no upfront fees, and we start with a complimentary financial analysis and projections report so you understand potential outcomes before proceeding.
SPECIALTIES