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 complex payer disputes and underpaid claims.
Healthcare reimbursement has grown increasingly complex with heightened regulatory ramifications and 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, while strong in core billing and coding for in-network claims, lack the niche legal, regulatory, and operational infrastructure needed for consistent success in the out-of-network domain. This partnership reflects a growing industry trend of RCM firms turning to specialized partners for OON and IDR workstreams that demand different expertise levels.
Out-of-network recovery and IDR arbitration are no longer extensions of routine accounts receivable according to Maverick Johnson, CollectionPro spokesperson. They are legal-regulatory processes that require mastery of NSA rules, Qualified Payment Amount benchmarks, documentation standards, and arbitration strategy. The company's role is to become the specialist engine behind RCM companies that want results without building this capability in-house.
CollectionPro's 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 legal acumen. The company reports top-notch performance metrics with 10,000 cases contested and a 92% success rate. Their turnkey dispute management covers claim analysis, scrubbing, document collection, re-coding, re-filing, arbitration process management, and post-award recovery. Their contingency-based pricing model of just 10% aligns fees strictly with recovered revenue, allowing RCM partners to offer OON and IDR services without fixed costs, specialized hiring, or regulatory risk assumption.
Since the No Surprises Act implementation in 2022, IDR case volume has surged beyond initial federal projections. Providers and RCM companies face mounting backlogs, rising arbitration fees, and increasingly technical payer arguments tied to Qualified Payment Amounts, coding, and medical necessity. For many RCM firms, the choice is between investing heavily in building an in-house NSA-IDR practice or partnering with a specialist operating at scale. RCM companies are realizing that OON and IDR are not just another workflow; they are a separate discipline according to Johnson. These partnerships allow them to protect client revenue, enhance their service portfolio, and stay compliant, without diluting focus from their core operations.
This partnership marks another milestone in CollectionPro's expansion as the dedicated OON and IDR partner 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. Additional information about their specialized services and approach to complex claims management is available at https://www.collectionproservices.com.
