Independent Dispute Resolution (IDR)

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Win more-and win bigger-for underpaid out-of-network claims.

The No Surprises Act created a formal pathway to dispute underpayments for out-of-network (OON) claims, but few providers are taking advantage of their opportunity to address all eligible claims and see new revenue. IDR is also complex, time-bound, and difficult to execute at scale.

Our purpose-built technology, supported by our expert team, quickly analyzes OON claims to determine IDR eligibility, then works through right channels from start to finish to find the appropriate level of reimbursement. Our industry-leading win rates deliver payouts averaging 3x the payer’s initial reimbursement offer.

See the results that matter:

  • Unlock a new revenue stream
  • Win payer disputes
  • Maximize reimbursements
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CASE STUDY

Learn how Knowtion helped one health system maximized payments through the IDR process.

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The Challenge

One midwestern health system with $770M in net patient revenue aimed to improve recovery performance from Open Negotiation to IDR among emergency department claims that fall into the NSA in a bifurcated state. They partnered with Knowtion to maximize reimbursement.

The Solution

To recover the revenue, Knowtion’s team and technology:


  1. Acquired, configured, and validated data.

  2. Assessed IDR opportunities and submitted open negotiation offers to the payer.

  3. Evaluated payer payment proposals, either accepting or declining them.

  4. Automated information collection and submissions via the IDR portal.

  5. Tracked the status of outstanding claims and the payment status of winning claims.

  6. Identified and collected revenue on additional like-service claims during 90-day cooling-off period.

The result

In six months, Knowtion won the health system $458K through the NSA IDR process.

263 claims processed

99% 99% IDR win rate

150% higher reimbursement than initially received, on average

4:1 ROI

Why do leading health systems choose Knowtion Health?

Providers are winning big in nearly all cases, often tripling payers’ initial reimbursement offers with our expert-led, tech-enabled, data-driven approach.

Discover the Knowtion difference.

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Increase reimbursement risk-free with our tech and expertise.

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