CollectionPro, a specialist in Independent Dispute Resolution (IDR) and out-of-network collections, has announced an expansion of its recovery services tailored for complex medical specialties. With a 92% win rate in arbitrations under the No Surprises Act (NSA), the firm aims to address the financial challenges faced by surgical, orthopedic, and interventional pain practices. The company operates on a pure contingency model, eliminating upfront arbitration fees that can exceed $1,200 per dispute, and charges a 10% success fee only upon winning.
Since the NSA's implementation, healthcare providers have struggled with administrative complexity and underpayments. CollectionPro focuses exclusively on out-of-network claims, providing legal and analytical scrutiny for each case. Under the leadership of David Nissanoff, the firm has handled over 10,000 cases, utilizing proprietary data and specialty-specific arguments to counter unfair payer benchmarks. Nissanoff stated, "The No Surprises Act was intended to protect patients, but it should not be used by insurers to systematically underpay specialized providers."
The IDR process requires action within 30 days of an Explanation of Benefits (EOB). CollectionPro manages the entire lifecycle, including claim analysis for IDR eligibility, a mandatory 30-day negotiation window, arbitration management by selecting optimal IDR entities, and live tracking through an integrated dashboard. The firm also recovers aged receivables, re-filing out-of-network claims that are 12 to 36 months old, allowing practices to capture previously written-off revenue.
CollectionPro advises providers on appropriate fee settings, moving beyond basic Medicare multiples to reflect true market rates. Its team includes in-house state-licensed lawyers who navigate federal NSA rules and state-specific laws, such as those in New Jersey and California. If an insurer fails to pay a won award, CollectionPro pursues enforcement via CMS reporting and legal follow-up.
Through a secure portal, providers gain transparency into EOBs and patient details. Once OON claims are submitted, CollectionPro handles the entire dispute lifecycle, from scrubbing claims for eligibility to filing the dispute. The firm's approach is designed to convert a costly administrative burden into a predictable revenue stream, aligning its goals with those of healthcare providers.
