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IDR for Emergency Medicine

No Surprises Act IDR filing for emergency medicine groups

Emergency services make up more than half of all federal IDR disputes. If your group is out of network with major payers and not filing, you are leaving the largest single category of recoverable revenue on the table.

Why emergency medicine dominates IDR

Emergency care is the core case the No Surprises Act was written for: patients can't choose their ER, so balance billing is banned and the payment dispute moves to the provider and plan. Emergency claims are high-volume, use a small set of E/M codes, and batch well — which is why over 630,000 emergency determinations were issued in the second half of 2025 alone.

What emergency disputes pay

Median emergency-service awards were 324% of QPA in Q3 2025 and 296% in Q4 2025 (CMS supplemental tables). For a group paid at QPA on thousands of 99283–99285 visits, that gap is material.

How we run it for ER groups

  • Weekly remit review by payer and code, with automatic open-negotiation notices on eligible underpayments
  • Batching by payer, code, and facility to keep IDR fees per claim low
  • Offer pricing from emergency-specific determination data in your market
  • Award tracking and late-payment escalation across every payer
Facility and professional: we file both hospital emergency department claims and physician-group claims, and handle the different batching rules for each.

What we need to start

90 days of out-of-network remits, your payer list, and a signed authorization. We return a claim-level eligibility report and projected recovery within a week.

Free eligibility review

Find out what your out-of-network claims are actually worth.

Send us a sample of recent OON remits. We'll tell you which claims are IDR-eligible, what similar disputes have paid, and what we'd file. No fee unless we win you more.

Request a free eligibility review