The rise of the “IDR middlemen” is one of the clearest examples of how the arbitration process under the No Surprises Act is wrapping the health care system in red tape and increasing costs for patients and employers. A recent BusinessMole article highlights how CollectionPro has built a business model around exploiting the law’s arbitration process, effectively turning it into a revenue-generating cash machine to pad its bottom line.
Branding itself as a “leading” provider of out-of-network claims solutions, CollectionPro is touting more than 10,000 cases resolved through the law’s arbitration process, also known as the independent dispute resolution (IDR) process. While the company deceptively frames this as a “relentless pursuit of justice,” what it truly shows is how a law meant to protect patients is being corrupted into a profit-driven business strategy for out-of-network providers.
CollectionPro boasts about recovering millions through individual claims. Behind their “wins” is a strategy that floods the arbitration system, a trend that will inevitably stick employers and employees with higher costs.
To protect consumers from inflated arbitration awards and price gouging, the Coalition Against Surprise Medical Billing (CASMB) urges the Trump administration to implement common-sense reforms, including:
- Addressing persistent claim eligibility issues that lead to wasteful, exorbitant costs on ineligible claims by affirming claim eligibility for IDR and discouraging initiating ineligible disputes;
- Monitoring and correcting longstanding provider misuse of the arbitration process that drives up employer and employee costs by developing a series of metrics to monitor problematic provider behaviors; and
- Improving system transparency and oversight with enhanced information sharing and performance monitoring by:
- Enhancing access within the IDR portal and requiring transparent information sharing and rationales; and
- Establishing IDRE performance metrics and audits tied to corrective action;
Read the full article from BusinessMole article online here. To learn more, visit https://stopsurprisebillingnow.com/.
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