CollectionPro has introduced a guaranteed 100% recovery model for out-of-network healthcare claims through Independent Dispute Resolution under the No Surprises Act, fundamentally altering how providers manage denied or underpaid claims. The company's zero-risk approach eliminates arbitration and administrative fees, requiring payment only when claims are successfully recovered. This expansion into California follows successful implementations in states including Florida and New York, addressing critical needs among providers struggling with payer underpayments and complex reimbursement structures.
The model features an industry-low 10% success-based fee and handles claims up to 365 days old from any facility or provider type, covering Medicare, Medicaid, Medi-Cal, and all commercial payers. Central to CollectionPro's offering is their team of No Surprises Act specialist attorneys who have handled over 10,000 arbitrations with a 92% success rate. The company promises to deliver five times the amount typically offered by payers, providing a crucial financial lifeline to practices that traditionally receive only up to 50% reimbursement for out-of-network services.
This approach ensures providers receive fair compensation without the burden of endless disputes and hidden fees that have historically plagued healthcare collections. The company's comprehensive service includes claim scrubbing, refiling, and arbitration at no additional cost, coupled with detailed weekly and on-demand reporting for complete transparency. This technological integration with legal expertise represents a significant shift from traditional aggressive collections to smart, compliant recovery methods that align with current regulatory requirements under the No Surprises Act guidelines available at https://www.cms.gov/nosurprises.
California healthcare providers, particularly affected by payer tactics that delay or deny rightful reimbursements, stand to benefit significantly from this solution. CollectionPro's model empowers providers with legal recourse and guaranteed claim recovery, preventing vulnerability to payer-controlled negotiations while ensuring regulatory compliance throughout the dispute resolution process. The service addresses the financial strain many practices face when dealing with underpaid claims, offering a structured approach that maximizes recovery while minimizing administrative burden and financial risk for healthcare facilities.
