Managed No Surprises Act IDR That Turns Awards Into Collected Cash
Out-of-network underpayments can quietly erode your margins, even when routine billing runs well. The federal independent dispute resolution (IDR) process gives your practice a way to challenge those payments, but it is deadline-driven, documentation-heavy and easy to underuse. Polarity IDR is our managed IDR program, built inside a physician-owned radiology practice in Houston, Texas, and designed to turn eligible disputes into cash in your account.
You keep your current biller. We identify eligible claims, run the federal IDR process end to end, follow every award through to payment and report what was actually collected.
What Is No Surprises Act IDR?
The No Surprises Act created a federal process that out-of-network providers and health plans can use to resolve payment disputes for certain items and services. When a payer’s initial payment or denial falls short, the provider can start a required open negotiation period. If the parties do not reach agreement, either side may initiate IDR.
A certified IDR entity then reviews each party’s offer and supporting information and selects one offer as the payment amount. Because the reviewer chooses between the two offers, the strength of your documentation, your offer strategy and your attention to federal deadlines all shape the outcome.
Who Qualifies for Federal IDR?
Not every underpaid claim is eligible. Eligibility depends on the service, the patient’s coverage, applicable federal or state rules and filing deadlines. Claims that commonly fall within the federal process include:
Emergency services:
Care provided by out-of-network physicians and facilities.
Hospital-based specialties:
Non-emergency services from out-of-network clinicians at in-network facilities, such as radiology, anesthesiology, pathology and emergency medicine.
Self-funded employer plans:
Many claims under plans not governed by a state dispute process.
In Texas and some other states, certain fully insured plans may follow a state process instead. We evaluate each claim so your recovery strategy targets disputes with a viable path forward.
Our IDR Process
We manage every step, so your team doesn’t have to track federal timelines claim by claim:
Eligibility and QPA review:
Identify out-of-network claims that may qualify and review payments against the qualifying payment amount (QPA).
Open negotiation:
Initiate and manage the required negotiation period with the payer.
Dispute filing and documentation:
Prepare, document and file disputes with a deliberate offer strategy.
Deadline management:
Track federal timelines so eligible claims are not lost to timing.
Award tracking and payment follow-up:
Monitor determinations and pursue unpaid or short-paid awards.
Award-to-cash reporting:
Reconcile awards to payments so you see collected dollars, not just wins.
Payer intelligence:
Use determination analysis to inform future filings and your payer negotiations.
Our streamlined approach typically reduces the time from the start of the IDR process to the award to as little as 72 days.
Why Award-to-Cash Matters
A win rate shows how often determinations favor the provider. It does not show how much of each award becomes cash or how long payment takes. An award only matters to your practice once it is paid.
That is why we measure success by incremental cash collected after fees and dispute costs. We track unpaid awards, follow up with payers and report time to payment, so your leadership can see whether the program is truly improving your practice’s finances. Before pursuing a dispute, we also weigh the potential additional payment against fees, dispute costs and collection timing.
Why Choose Polarity for IDR?
We built this capability to solve our own problem. When our founding Houston radiology practice was forced out-of-network by major insurers after the No Surprises Act, we engineered a proprietary IDR strategy to fight back.
Proven results:
An all-time 98% IDR win rate, with a 99% collection rate on those wins.
Focused on IDR, not just billing:
A dedicated recovery layer rather than another claims-processing service.
Shaping the rules:
We contributed to the TMA IV legal challenge that reduced federal administrative filing fees and invalidated restrictive claim-batching rules.
Works with your biller:
Your billing company keeps processing claims while we focus on IDR.
Physician-built:
Created inside a physician-owned practice that shares your priorities.
“No one in the country manages the NSA IDR process better than Polarity. To put it simply, they have this process mastered.”
Ron Howrigon, Founder, Fulcrum Strategies
Polarity IDR FAQs
Does every underpaid claim qualify for IDR?
No. Eligibility depends on the service, insurance coverage, applicable federal or state rules and filing deadlines. We evaluate your claims so your strategy focuses on disputes with a viable path to payment.
Can Polarity work with our current biller?
Yes. Polarity IDR is designed to work alongside your existing billing operation. Your biller continues to process claims, while we identify eligible disputes, run the IDR process and reconcile awards to payments.
What information do you need to evaluate our opportunity?
A review typically starts with claims, payment and remittance data, along with relevant payer correspondence. These records help us identify reimbursement gaps, assess eligibility and estimate recovery potential.
Is pursuing a dispute always worth the cost?
Not necessarily. The potential additional payment must be weighed against fees, dispute costs and collection timing. We focus on the net financial benefit to your practice, not the number of disputes filed.
What if we already have an IDR program?
An existing program may still leave opportunities unexplored. A Revenue Performance Review can assess eligible claim capture, collection performance and net returns to show where improvement may be possible.
See What Polarity IDR Could Recover for Your Practice
Whether your practice is in Houston or anywhere in the country, we can evaluate your opportunity and propose a focused IDR pilot covering eligible revenue, expected costs, time to cash and potential net return.
Request a Revenue Performance Review❯