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A single air transport can be one of the largest claims a health plan sees. When the plan's payment falls short, LibeCore uses federal Independent Dispute Resolution (IDR) to pursue fair reimbursement for your crews and aircraft.
Request a Free Legacy AuditAir ambulance services—both rotor-wing and fixed-wing—are covered by the No Surprises Act. Patients transported by an out-of-network air ambulance owe only the cost sharing they would have paid in network, and can't be balance-billed. The plan makes an initial payment or sends a denial, and if that payment is too low, your recourse is open negotiation and then IDR. Ground ambulance services are not part of the federal IDR process.
Unlike high-volume specialties, air ambulance claims are few and large. A shortfall on a single transport can be substantial, so many claims are worth disputing individually—and each one deserves a carefully built case rather than a template.
After receiving your claim, the plan has 30 calendar days to send an initial payment or a notice of denial. With that payment, the plan must disclose its qualifying payment amount and information about how it was calculated. That starts a 30-business-day open negotiation period; if it fails, either side can initiate IDR within 4 business days after it ends.
A 30-business-day negotiation window opens after the plan's initial payment or denial.
If unresolved, we file within 4 business days through the CMS Federal IDR portal.
We assemble the evidence and payment offer the arbitrator will weigh.
A certified arbitrator selects one offer, and the plan must pay within 30 calendar days.
Alongside the plan's qualifying payment amount (QPA), federal law lists additional factors the arbitrator may consider specifically for air ambulance disputes: the quality and outcomes measurements of the provider, the acuity of the patient's condition, the training, experience, and quality of the medical personnel, the ambulance vehicle type and its clinical capability level, the population density of the pick-up location, and each side's good-faith efforts to contract. Rural pick-ups, critical-care crews, and specialized aircraft are exactly the details that belong in your offer.
We review your out-of-network transports, complete open negotiation, and file through the CMS portal within the deadline. We assemble the evidence the law calls for—transport records, crew credentials, aircraft capability, and pick-up location—and manage the arbitration through to payment.
Does the No Surprises Act cover ground ambulance?
No. Ground ambulance services aren't part of the federal IDR process, though some states have their own rules. Air ambulance—rotor-wing and fixed-wing—is covered.
How long does IDR take once it starts?
After the arbitrator is selected, both sides submit offers within 10 business days, and the arbitrator decides within 30 business days. If you win, the plan must pay within 30 calendar days of the decision.
Can we bill the patient while the dispute is pending?
No. Covered patients owe only their in-network cost sharing. The payment dispute is between you and the plan.
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