CollectionPro Services LLC has announced a strategic partnership with a prominent Revenue Cycle Management company to manage and resolve its growing volume of out-of-network claims. This collaboration positions CollectionPro as the dedicated Out-of-Network and No Surprises Act Independent Dispute Resolution arm for the billing organization, bringing specialized expertise to an increasingly complex healthcare reimbursement landscape.
Healthcare reimbursement has grown more complex with increased regulatory ramifications and intensified payer scrutiny, making OON claims and NSA-IDR arbitration one of the most specialized and high-risk areas within revenue cycle operations. Many full-service RCM companies, despite strength in core billing and coding for in-network claims, lack the niche legal, regulatory, and operational infrastructure required for consistent success in the out-of-network domain. This partnership reflects a growing industry trend of RCM firms turning to specialized partners to manage OON and IDR workstreams that demand different expertise.
"Out-of-network recovery and IDR arbitration are no longer extensions of routine A/R," commented Maverick Johnson, spokesperson for CollectionPro. "They are legal-regulatory processes that require mastery of NSA rules, QPA benchmarks, documentation standards, and arbitration strategy. Our role is to become the specialist engine behind RCM companies that want results without building this capability in-house."
CollectionPro's core differentiation lies in its singular focus on NSA-IDR and OON recovery, supported by resident NSA and IDR experts with hands-on arbitration experience and strong legal acumen. The company reports top-notch performance metrics with 10,000 cases contested to date and a 92% success rate. Their turnkey dispute management covers the entire process from claim analysis and scrubbing to collecting requisite documents, re-coding and re-filing, pushing corrected claims through arbitration, and post-award recovery.
The company operates on a low, contingency-based pricing model of just 10%, aligning fees strictly with recovered revenue. This approach allows RCM partners to offer OON and IDR services to their provider clients without incurring fixed costs, hiring legal specialists, or assuming regulatory risk. Since the implementation of the No Surprises Act in 2022, the volume of IDR cases has surged far beyond initial federal projections, creating mounting backlogs, rising arbitration fees, and increasingly technical payer arguments tied to Qualified Payment Amounts, coding, and medical necessity.
"RCM companies are realizing that OON and IDR are not just another workflow; they are a separate discipline," said Johnson. "Our partnerships allow them to protect client revenue, enhance their service portfolio, and stay compliant, without diluting focus from their core operations." This latest partnership marks another milestone in CollectionPro's expansion as the dedicated OON and IDR partner of choice for RCM organizations across the United States. By combining regulatory depth, arbitration expertise, and performance-based pricing, CollectionPro enables RCM companies to transform one of healthcare's most challenging reimbursement problems into a predictable, recoverable revenue stream.
