We run the federal process that gets out-of-network claims paid

Since 2022, an out-of-network emergency claim underpaid by a health plan is no longer a write-off and no longer a patient balance. It is a dispute with a defined path: an open negotiation period with the payer, and if that fails, Independent Dispute Resolution before a certified entity that picks one of the two submitted offers.

That path is procedurally demanding. There are deadlines that start running the moment a payment or denial notice arrives, eligibility rules about which claims qualify, batching rules that determine whether related claims can be submitted together, and administrative fees that make some disputes uneconomic and others clearly worth running. Miss a window and the claim is finished regardless of its merits.

We own that work: qualification, the open negotiation stage, offer preparation with supporting documentation, submission, and tracking through to determination. Groups with real out-of-network volume are often leaving substantial money uncollected, not because anyone decided to, but because the work sits outside routine billing and nobody owns it. That is the gap we exist to close.

It works best alongside routine billing rather than in isolation, because deciding what to dispute requires seeing the payment patterns across the whole book. But it can be run standalone against claims someone else billed.