Meaningful out-of-network underpayments
Designed for claims where the potential recovery justifies specialized pursuit.
IDR execution for provider teams
Pursue eligible underpayments without adding IDR work to your team.
Provider Recovery Partners manages provider-side independent dispute resolution (IDR) under the No Surprises Act (NSA) and supported state pathways—with claim-level reporting, routing controls, secure intake, and outcome tracking.
Federal IDR New York New Jersey Florida Texas
What PRP manages
01Pathway routing
02Eligibility review
03Document control
04Deadline management
05Reporting and reconciliation
Four standard claim documents plus one-time practice and provider onboarding information.Federal/state pathway routing
Claim-level dashboard visibility
Document and deadline controls
Who we help
Built for claims worth pursuing.
PRP works with individual providers and provider groups that need focused IDR execution without building another internal operating function.
Four standard claim documents
Insurance card, provider EOB or RA, CMS-1500, and operative notes, uploaded through PRP’s separate secure application after onboarding.
Federal or supported state process
Potentially eligible federal matters nationwide, plus applicable state disputes in NY, NJ, FL, and TX.
Claim-value and volume minimums apply. The consultation and PRP-requested claims review are both complimentary.
How it works
You provide the records.
PRP controls the workflow.
Route the claim
We review plan, venue, timing, and payment facts to determine whether federal IDR or a supported state process may apply.
Confirm fit and independence
PRP checks claim-specific eligibility, operating fit, and independence considerations before pursuit.
Control documents and deadlines
We organize the submission file, deadline calendar, notices, evidence, and missing-item follow-up.
File and negotiate
PRP manages filing, communications, negotiation, and case updates throughout the applicable process.
Reconcile and report
Claim-level reporting keeps stages, outcomes, multi-EOB activity, and incremental recovery visible to your team.
Standard claim intake
For most claims, four documents are enough.
After onboarding, PRP provides a separate secure application URL for uploading the standard claim file. PRP will organize it for eligibility review, negotiation, and dispute preparation.
01Patient insurance card
02Provider EOB or RA
03CMS-1500
04Operative notes
Practice and provider profile
Before the first matters are submitted, PRP will collect basic practice and provider information, including a provider CV.
Unusual casesAdditional documentation may occasionally be required. PRP will identify the specific item when the claim calls for it.
Secure exchange onlyThese materials may contain PHI. Submit them only through the separate secure application URL PRP provides after onboarding—not through this public website or the scheduling flow.
Claim-level visibility
Claim-level reporting, not a black box.
The client dashboard makes stage, deadlines, actions, outcomes, multi-EOB activity, and recovery reporting visible without pulling your staff into day-to-day administration.
ClaimPathwayStageLatest activity
PRP–2481FederalOpen negotiationPayer response logged
PRP–2537New YorkEvidence preparationDocumentation organized
PRP–2604TexasOutcome trackingPayment status monitored
Illustrative claim data. Live client views reflect actual matters.Aligned commercial model
Measured recoveries, not headline win rates.
Incremental recovery
The amount ultimately paid
minus the amount originally paid.
Current coverage
Nationwide federal IDR plus four supported state pathways.
Federal IDR may apply to eligible claims nationwide. PRP reviews facts before routing a matter so federal and supported-state pathways are not treated as interchangeable.
Federal independent dispute resolution
Potentially eligible matters nationwide under the federal process.
New York
Applicable disputes under the supported state pathway.
New Jersey
Applicable disputes under the supported state pathway.
Florida
Applicable disputes under the supported state pathway.
Texas
Applicable disputes under the supported state pathway.
Eligibility depends on the specific claim, plan, date, venue, and other facts. PRP confirms the available pathway before work begins. Review the coverage guide.
IDR insights
Understand the process before the deadline.
Source-backed guidance for provider teams navigating federal IDR and the No Surprises Act.
Frequently asked questions
What teams usually want to know first.
PRP is designed for potentially eligible out-of-network claims with meaningful underpayment opportunity. Federal or supported state eligibility depends on the specific claim facts, and claim-value and volume minimums apply.
For a standard claim, PRP needs the patient insurance card, provider EOB or RA, CMS-1500, and operative notes. At startup, we also collect practice and provider information, including a provider CV. Unusual cases may require additional documentation, which PRP will identify specifically. After onboarding, sensitive records are uploaded through the separate secure application URL PRP provides—never through the public website or scheduling flow.
PRP supports provider-side federal independent dispute resolution (IDR) under the No Surprises Act (NSA) nationwide, plus applicable state processes in New York, New Jersey, Florida, and Texas.
The commercial model is a contingent percentage of incremental recovery. Incremental recovery means the amount ultimately paid minus the amount originally paid.
Clients receive dashboard visibility into claim status, deadlines, actions, outcomes, and recovery reporting.
Choose the next step
Start without sharing PHI.
Schedule a consultation, request an email follow-up, or organize the business information PRP will need. Both the consultation and PRP-requested claims review are complimentary.
Prepare for follow-up reviewView the intake checklistAsk a general question