CollectionPro, a specialist in Independent Dispute Resolution (IDR) and out-of-network (OON) collections, announced an expansion of its recovery services tailored for complex medical specialties facing challenges under the No Surprises Act (NSA). The firm reports a 92% win rate in IDR arbitrations, significantly above the industry average, by leveraging proprietary data and specialty-specific arguments to counter unfair payer benchmarks.
Since the NSA took effect, healthcare providers have struggled with administrative complexity and underpayments. CollectionPro focuses exclusively on OON claims, handling over 10,000 cases under the leadership of David Nissanoff, a recognized expert in healthcare arbitration. The firm's approach includes customized pricing strategies that reflect true market rates, jurisdictional expertise in federal and state surprise billing laws, and aggressive enforcement against insurers that fail to pay awarded amounts.
A key barrier for providers is the high cost of arbitration, which can exceed $1,200 per dispute. CollectionPro eliminates these upfront fees by operating on a pure contingency model: the firm fronts all administrative and arbitration costs, charging a 10% success fee only if the provider wins. This performance-based structure aligns the firm's goals with those of healthcare providers, turning administrative burden into a predictable revenue stream.
CollectionPro assists providers in identifying CPT codes and facility settings (places of service 21, 22, 23, and 24) that qualify for maximum recovery. Services include claim analysis for IDR eligibility, management of the mandatory 30-day negotiation window, arbitration filing with optimal IDR entities, and real-time status updates through an integrated dashboard. The firm also recovers aged receivables—claims 12 to 36 months old—that were previously considered write-offs.
The No Surprises Act was intended to protect patients from surprise medical bills, but it has also enabled insurers to systematically underpay specialized providers. CollectionPro acts as the legal and operational backbone for practices, ensuring that out-of-network providers are compensated for the true value of their expertise. With a focus on specialized care, the firm provides a robust, zero-risk pathway for revenue recovery.
