CollectionPro Services LLC has announced a strategic partnership with a prominent Revenue Cycle Management company to manage and resolve its growing volume of out-of-network claims. This collaboration positions CollectionPro as the dedicated Out-of-Network and No Surprises Act Independent Dispute Resolution arm for the billing organization, bringing specialized expertise to an increasingly complex healthcare reimbursement landscape.
Healthcare reimbursement has grown more complex with increased regulatory ramifications and intensified payer scrutiny, resulting in out-of-network claims and NSA-IDR arbitration emerging as specialized, high-risk areas within revenue cycle operations. Many full-service RCM companies, despite strength in core billing and coding for in-network claims, lack the niche legal, regulatory, and operational infrastructure required for consistent success in the out-of-network domain. This partnership reflects a growing industry trend of RCM firms turning to specialized partners for OON and IDR workstreams that demand different expertise levels.
"Out-of-network recovery and IDR arbitration are no longer extensions of routine A/R," commented Maverick Johnson, CollectionPro spokesperson. "They are legal-regulatory processes that require mastery of NSA rules, QPA benchmarks, documentation standards, and arbitration strategy. Our role is to become the specialist engine behind RCM companies that want results without building this capability in-house."
CollectionPro's core differentiation lies in its singular focus on NSA-IDR and OON recovery, supported by resident NSA and IDR experts with hands-on arbitration experience and legal acumen. The company reports top-notch performance metrics with 10,000 cases contested and a 92% success rate. Their turnkey dispute management covers claim analysis, scrubbing, document collection, re-coding, re-filing, pushing corrected claims through arbitration, and post-award recovery. Their contingency-based pricing model of just 10% aligns fees strictly with recovered revenue, allowing RCM partners to offer OON and IDR services without fixed costs, legal specialist hiring, or regulatory risk assumption.
Since the No Surprises Act implementation in 2022, IDR case volume has surged beyond initial federal projections. Providers and RCM companies face mounting backlogs, rising arbitration fees, and increasingly technical payer arguments tied to Qualified Payment Amounts, coding, and medical necessity. For many RCM firms, the choice involves either heavy investment in building in-house NSA-IDR practice or partnering with specialists operating at scale. More information about healthcare reimbursement challenges can be found at https://www.cms.gov/nosurprises.
"RCM companies are realizing that OON and IDR are not just another workflow; they are a separate discipline," said Johnson. "Our partnerships allow them to protect client revenue, enhance their service portfolio, and stay compliant, without diluting focus from their core operations." This partnership marks another milestone in CollectionPro's expansion as the dedicated OON and IDR partner for RCM organizations across the United States, combining regulatory depth, arbitration expertise, and performance-based pricing to transform challenging reimbursement problems into predictable revenue streams.
