An IDR Award Is Not Optional
Halkovich Law examines the federal 30-calendar-day payment rule and the records providers should preserve when a final IDR determination remains unpaid.
Read the Halkovich Law analysisInsights
Healthcare reimbursement insights for providers.
Analysis of No Surprises Act arbitration, payer conduct, reimbursement policy, and the practical decisions that shape provider recovery.
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Provider-side perspective on reimbursement developments.
Federal Agencies Add a 17th Certified IDR Entity
Physio Solutions, LLC, doing business as medlitix, has joined the federal IDR roster. CMS currently lists the organization as not accepting new disputes.
Read the news brief1,700 Fewer Prior Authorizations—But Providers Still Need a Verification Plan
UnitedHealthcare's October reduction is meaningful. Halkovich Law explains why practices still need code-, plan-, state-, and patient-specific proof before changing workflows.
Read the Halkovich Law analysisWhen Insurers Downcode Claims, Providers Pay Twice
Halkovich Law examines the reimbursement loss and administrative burden created by recurring downcoding—and the records providers should preserve now.
Read the Halkovich Law analysisWhat the $22 Billion IDR Cost Report Leaves Out
Halkovich Law responds to the Fierce Healthcare report with the missing context: reported award errors, health-plan defaults, nominal offers, and the disputed QPA benchmark.
Read the Halkovich Law analysisOut-of-Network Reimbursement and No Surprises Act Q&A with Jeffrey Halkovich
Hear Jeffrey discuss claim eligibility, QPA-based payments, open negotiation, IDR documentation, and the administrative mistakes that can cost providers recovery opportunities.
Listen to the full Q&AWhat Insurer Challenges to the No Surprises Act Mean for Healthcare Providers
Halkovich Law examines an opinion in The Hill about insurer challenges, initial payment offers, IDR outcomes, and award enforcement—then outlines the records providers should preserve.
Read the Halkovich Law analysisWhat the Fifth Circuit's QPA Ruling Means for Healthcare Providers
A federal appeals court rejected important parts of the methodology used to calculate the qualifying payment amount. Halkovich Law examines the decision's implications for QPA review, negotiation, documentation, and federal IDR strategy.
Read the Halkovich Law analysisWhat the Latest Federal IDR Data Means for Healthcare Providers
Halkovich Law examines the New York Times coverage and RevGuard's response, then considers the practical implications for claim screening, eligibility, documentation, and enforcement.
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