The federal No Surprises Act (NSA), effective January 1, 2022, shifted the out-of-network payment dispute away from the patient and directly between you and the insurer, through a binding federal arbitration process called Independent Dispute Resolution (IDR).
When an insurer underpays for emergency or inadvertent out-of-network care, you now have a federal pathway to challenge it. A neutral, CMS-certified arbitrator reviews both sides and issues a binding, enforceable decision.
The problem: strict deadlines, complex documentation requirements, and insurers using artificially low QPAs as anchors, knowing most providers won't push back effectively.
Insurer sends initial payment (typically near QPA). You have 30 business days to request open negotiation.
Either party initiates formal negotiation. Most insurers stall, betting you'll give up.
If negotiation fails, you must file through the federal IDR portal within 4 business days. Missing this forfeits your claim forever.
Parties jointly select or are assigned a CMS-certified arbitration entity.
Both parties submit their best offer and supporting documentation. Evidence quality is decisive.
Arbitrator selects one offer. Per AFHC data, 52% of awarded amounts are never paid; 49% of payments are late. Post-award enforcement is essential.
If you've delivered emergency or inadvertent out-of-network care, you likely have recoverable revenue, possibly from years ago.
Every capability is backed by our proprietary legal framework and in-house attorneys.
NSA Recovery manages the entire lifecycle, you focus on patients, we handle everything else.
An AFHC survey of more than 48,000 physicians across 45 states found that after the IDR process concludes, payers routinely fail to comply with arbitration decisions. Most firms declare victory at the award and move on, leaving the majority of your money on the table.
NSA Recovery pursues full collection on every award as a standard part of our service.
Most NSA services are billing companies using software, or law firms without scalable technology. NSA Recovery is built around a proprietary legal framework with in-house attorneys at every stage.