CollectionPro, a specialist in Independent Dispute Resolution and out-of-network collections, has expanded its services to address the financial challenges surgical, orthopedic, and interventional pain practices face under the No Surprises Act. The firm maintains a 92% success rate in arbitrations, significantly higher than industry averages, by focusing exclusively on complex medical specialties and utilizing proprietary data strategies.
The No Surprises Act, while designed to protect patients from unexpected medical bills, has created administrative complexity for healthcare providers. Routine billing departments often struggle with the technical requirements of the IDR process, leading to underpayments or missed filing deadlines. CollectionPro addresses this by serving as a dedicated resource for all IDR cases, providing the legal and analytical scrutiny needed to secure fair compensation for specialized medical services.
Under the leadership of David Nissanoff, a recognized expert in healthcare arbitration, CollectionPro has handled over 10,000 cases. The firm employs specialty-specific arguments to counter unfair payer benchmarks, ensuring providers receive payment that reflects the true value of their expertise. "The No Surprises Act was intended to protect patients, but it should not be used by insurers to systematically underpay specialized providers," Nissanoff stated.
One significant barrier to pursuing IDR claims has been the high cost of arbitration, with traditional vendors requiring upfront fees that can exceed $1,200 per dispute. CollectionPro eliminates this financial hurdle through a pure contingency model where the firm fronts all administrative and arbitration costs. Providers only pay a 10% success fee based on the gross award if they win, aligning CollectionPro's goals directly with those of healthcare practices.
The firm's advanced strategies include customized pricing that moves beyond basic Medicare multiples to reflect true market rates, jurisdictional expertise navigating both federal NSA rules and state-specific surprise billing laws, and aggressive enforcement through CMS reporting and legal follow-up when insurers fail to pay won awards. CollectionPro also identifies specific CPT codes and facility settings (places of service 21, 22, 23, and 24) that qualify for maximum recovery.
Through a secure, user-friendly portal, practices maintain transparency with access to Explanation of Benefits and patient details. Once out-of-network claims are submitted, CollectionPro manages the entire dispute lifecycle from claim analysis and open negotiation to arbitration management and live tracking via an integrated dashboard.
Beyond time-sensitive IDR claims requiring action within 30 days of an EOB, CollectionPro specializes in recovering aged receivables 12 to 36 months old. This revenue resurrection service allows practices to capture funds previously considered write-offs, significantly impacting year-end financial performance for healthcare providers navigating the complexities of out-of-network billing under current regulations.
