Frequently asked questions, answered plainly.
Fees, contracts and how the work runs. If your question is not here, ask us.
The basics
What is IDR?
Independent dispute resolution is the arbitration process set up by the No Surprises Act. When a plan underpays an out-of-network claim, the provider and plan negotiate for 30 business days. If they do not agree, either side can ask a certified IDR entity to pick one of the two offers.
Who is Revise for?
Out-of-network physician groups, ASCs, hospitals and air ambulance providers, and the billing companies that work for them. Groups under about $5M a year in out-of-network charges usually do better through their billing company on our engine tier.
Do you replace our billing company?
No. Most groups keep their billing company for everything else and move IDR to us. Billing companies can also run our engine under their own brand.
Is our data safe?
We sign a BAA before any data moves. Data stays in the United States, encrypted at rest and in transit, and every PHI read is logged.
Are you a law firm?
No. We represent you in open negotiation and IDR, but we do not give legal advice. Litigation goes to partner counsel you choose.
Fees and contracts
What do you charge?
19% of the cash that reaches your account on disputes we work. The payment you had before open negotiation is never counted. Groups above $50M a year in out-of-network charges get volume pricing.
Who pays the IDR fees?
We front every CMS and IDR entity fee and recoup it from the award on that dispute. If the payer never pays, the cost is ours.
What if the payer never pays the award?
You owe us nothing on it. We chase it with demand letters, state and CMS complaints, and referral to partner counsel.
Is there a long-term contract?
No. The first term is 90 days, then month-to-month with 30 days notice and no exclusivity. Open disputes finish under the same terms.
Can we switch from another IDR vendor?
Yes, usually in stages. We start with awards you already won but were never paid, at 8% with no fees. Open disputes stay with your current vendor, and new ones move to us when your contract allows.
How it works
What do you need from us to start?
One month of out-of-network remits (835 files) or an EOB export, your payer list and a signed BAA. Within seven business days you get a free report of claims you can still file and awards you were never paid.
How long does it take?
Open negotiation runs 30 business days before IDR can start. Once an award is made, the payer has 30 days to pay it.
What if a claim is ruled ineligible?
We absorb the admin and IDR entity fees on any dispute we filed that is ruled ineligible. Your statement shows our ineligibility rate.
Do you handle state processes too?
Yes. Texas, New Jersey, New York, Florida, Georgia and Washington at launch. Each claim goes to the state or federal process that applies.
Send us one month of remits.
We’ll show you what you left on the table.
Seven business days. No cost. A line-by-line report of eligible claims you didn’t file, QPAs that don’t add up, and awards you were never paid.