The highest dispute volume in the statute. An engine, not a queue.
Emergency physicians cannot choose their payers, so the No Surprises Act covers almost every out-of-network visit. That means thousands of modest claims, each with its own clocks.
Built for emergency medicineMost out-of-network visits are eligible
The codes the engine reads first.
Claims with the same service code, or a comparable code in another code system, can go in one batch of up to 50 items.
- 99281 to 99285Emergency department visit, levels 1 to 5
- 99291, 99292Critical care, first 30 to 74 minutes and each added 30
- 10060 to 12007Procedures done in the ED, such as incision and drainage and simple repairs
- 93010ECG interpretation billed with the visit
What the data says
- Providers prevailed in 85% of federal disputes in Q1 2024, up from 68% in Q1 2023.1
- Volume is concentrated: in the second half of 2024 the ten largest initiating parties filed about 71% of all disputes. The top three were a radiology practice, an IDR vendor and a physician staffing company.8
- At $15 per party, the federal admin fee no longer eats a small-dollar emergency claim before the dispute starts.2
How your claims reach a decision.
Step 1: Almost every visit qualifies
Emergency care is covered whether or not the patient chose the hospital.
Step 2: Federal or state, per claim
Self-funded plans go federal. Fully insured plans in states with their own law (Texas, New Jersey, New York, Florida, Georgia, Washington and others) go to the state process.
Step 3: Every call shows its reason
The engine picks the process for each claim and attaches the reason and the citation.
One claim, priced both ways.
Paid in full, the two fees are close. If the payer never pays, Revise costs you nothing.
Our fee if the payer never pays this award. An award-based fee of $208 stays due either way.
| Line | Amount |
|---|---|
| Billed charge | $2,400 |
| Initial payment (taken as the QPA) | $520 |
| Award at 3x the QPA | $1,560 |
| Added cash, if the payer pays in full | $1,040 |
| Award-based vendor, 20% of the uplift, due paid or not | $208 |
| Revise, 19% of cash collected | $198 |
| You keep with Revise, on this one claim | +$10 |
Illustrative. Assumes the award is paid in full. Fronted admin and IDRE fees not shown.
What breaks today. What changes with Revise.
Today
- Thousands of small claims a month, each with its own 30-business-day and 4-business-day windows.
- Vendor fees charged on awards that payers have not paid yet.
- No per-claim view of which IDRE decided what, or when the money is due.
With Revise
- Intake from 835s and EOB exports, deduped and assessed in hours.
- Batches built to the 50-item cap, with IDRE selection informed by outcome data.
- A 30-day payment clock on every award, with demand letters and complaints when it runs out.
One fee. Only on cash collected.
Our fee: 19% of cash collected. Nothing if we collect nothing.
Free claims audit to start- 01
We front every fee
CMS and IDRE fees are paid by Revise and recouped from the award. You fund no operating account.
- 02
Paid when you’re paid
Billed monthly on reconciled remits. If the payer doesn’t pay, neither do you.
- 03
No lock-in
90 days, then month-to-month with 30 days’ notice. No exclusivity.
Are low-acuity visits (99281 to 99283) worth disputing?
More often than before. With the admin fee at $15 per party, the threshold falls a long way. The engine scores each claim on expected cash after fees and only files where the math works.
How do you handle facility and professional claims from the same visit?
Separately. The professional claim is yours; the hospital files its facility claim. We can work both when the hospital is also a client, and the portal keeps them linked.
Our billing company already files some disputes. Can we split the work?
Yes. Many groups start with the claims their billing company does not touch, such as state disputes or unpaid awards, and move the rest once they see results.
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.
Sources
- 1McGough, Kurani and Long, "The performance of the federal independent dispute resolution process through mid-2024," Peterson-KFF Health System Tracker, May 29, 2025. Providers prevailed in 68% of disputes in Q1 2023 and 85% in Q1 2024; 80% across 2023 to mid-2024. Source
- 2CMS, No Surprises Act notices: the federal IDR administrative fee is $15 per party per dispute for disputes initiated on or after June 11, 2026 ($115 before). Source
- 8CMS, Federal IDR supplemental background, July to December 2024: 853,374 disputes initiated; the top ten initiating parties filed about 71% of them. Source