A typical out-of-network dispute, start to finish
Claim submitted
Charge captured & billed
QPA review
Payer offer benchmarked
Open negotiation
30-day window managed
IDR filed
Prevailing offer built
Determination
Payment collected
Step by step
Five stages, five deadlines.

We track every date so nothing lapses and no dispute defaults against you.

01

Qualifying Payment Amount review

Before initial notice

We evaluate the payer's QPA against market rate data before deciding whether to pursue negotiation or arbitration. This benchmarking shapes the entire dispute strategy that follows.

02

Open negotiation

30-day window

A 30-day window to negotiate directly with the payer. We manage all correspondence and hold the line on the deadline so the window is never missed.

03

IDR initiation

4 business days after negotiation ends

If negotiation fails, we file with a certified IDR entity and select an arbitrator within the required federal timeframe.

04

Prevailing offer submission

10 business days after entity selection

We build the evidentiary case — market data, complexity factors, provider qualifications — behind your offer to give it the best chance of prevailing.

05

Determination & collection

30 business days to a ruling

Once the arbitrator rules, we track payment through to posting and reconcile it against the original claim so nothing falls through the cracks.

Let's see what your out-of-network claims are actually worth.

Schedule a call →