A guide for independent practices
A one-page overview of IDR, how PRP manages claims, and what your practice provides.
1 page · PDFDownload the practice overview (PDF)IDR insights and operating resources
Independent dispute resolution guidance for provider and RCM teams.
Evergreen, source-backed explanations of federal IDR, the No Surprises Act (NSA), supported state pathways, claim intake, and operating execution.
Run IDR without adding a dedicated internal team
Divide the work with your existing biller: records, negotiation, filing, exceptions, and payment reconciliation.
8 minute read · Sources checked October 2026Read the guideWhat to do about an underpaid out-of-network claim
Check the payment, preserve the deadline, and identify the appropriate dispute route before choosing a partner.
6 minute read · Reviewed October 2026Read the guideFederal IDR eligibility: the questions to answer first
A provider-side framework for checking the service, plan, pathway, payment response, and procedural timing.
7 minute read · Reviewed October 2026Read the guideThe federal open-negotiation period, operationally
What the 30-business-day period does, what to preserve, and how to prepare for the next deadline.
6 minute read · Reviewed October 2026Read the guideFederal IDR deadlines provider teams should control
A practical timeline covering open negotiation, IDR initiation, settlement notices, and payment after a determination.
6 minute read · Reviewed October 2026Read the guideA provider operations guide to the QPA
What the qualifying payment amount is, where it appears, and why clean QPA data matters during review.
6 minute read · Reviewed October 2026Read the guideBuilding a useful federal IDR evidence package
How to connect provider, service, acuity, and claim documentation to the payment offer without adding noise.
7 minute read · Reviewed October 2026Read the guideFederal IDR batching after the 2026 operations rule
What the new line-item limit and effective date mean for intake, grouping logic, documentation, and auditability.
5 minute read · Reviewed October 2026Read the guideWhat happens after an IDR payment determination
A controlled follow-through process for recording the result, monitoring payment, and escalating exceptions.
5 minute read · Reviewed October 2026Read the guideOutsourcing IDR without losing the client relationship
A decision guide for referral, co-branded, and white-label IDR delivery models.
6 minute read · Reviewed October 2026Read the guideFederal IDR and No Surprises Act glossary
Plain-language definitions for the terms provider and RCM teams encounter throughout the process.
Reference guide · Reviewed October 2026Read the guidePlan the RCM partnership with your team
Compare referral, co-branded, and white-label models, responsibilities, onboarding, and reporting.
2 pages · PDFDownload the partnership brief (PDF)What the 2026 Federal IDR operations rule changes
A practical provider-side summary of the communication, open-negotiation, batching, and eligibility changes.
8 minute read · Updated October 2026Read the guideThe standard four-document claim file
What PRP normally needs for a claim, what is collected once at startup, and how unusual cases are handled.
Printable guide · Reviewed October 2026Read the guideHow PRP defines incremental recovery
Understand determinations, collected cash, fees, and the questions to ask when comparing IDR reporting.
Operating walkthrough · Updated October 2026Read the guideFederal and state IDR by state
Compare federal IDR, state payment rules and self-funded plan opt-in in one chart.
State reference · Sources checked October 2026Read the guideSource standard
Official material first.
Regulatory content links to CMS, HHS, and state authorities wherever possible. Each guide carries a review date because rules, portals, fees, and procedures can change.
Articles are written by Benjamin Mankowitz and operationally reviewed by Provider Recovery Partners. PRP does not use resource content to guarantee a result or replace claim-specific eligibility analysis.
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