Contingency-based IDR recovery — get a free audit.
Hospitalists, intensivists, neonatologists, and assistant surgeons care for patients who chose the hospital, not the physician group. When plans underpay that care, LibeCore uses federal Independent Dispute Resolution (IDR) to recover what your group is owed.
Request a Free Legacy AuditThe No Surprises Act specifically lists hospitalists, intensivists, neonatology, and assistant surgeons among the ancillary services (alongside emergency medicine, anesthesiology, pathology, and radiology) for which patients can't be asked to waive their protections at an in-network facility. A hospital can be in network while your group isn't, and the patient owes only in-network cost sharing either way. The payment question is left to your group and the plan.
Hospital-based groups often cover several facilities, each with a different payer mix. Every underpaid claim starts its own 30-business-day negotiation period, followed by a 4-business-day window to file. Across multiple hospitals, tracking those deadlines by hand is where recoverable revenue quietly expires.
A single ICU or NICU stay can generate daily claims over weeks, each with its own negotiation clock. Federal batching rules let qualifying claims for the same or similar service, billed to the same plan and furnished within the same 30-business-day period, be grouped into one dispute. For critical care and neonatology groups, organizing those daily claims is often the difference between a dispute that's worth filing and one that isn't.
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.
Arbitrators weigh the plan's qualifying payment amount (QPA)—its median in-network rate—together with additional information: the acuity of the patient and complexity of the care, such as ICU and NICU stays; the training and experience of your physicians; market share; and good-faith efforts to join the plan's network. If your group has tried to contract with a plan and been turned down, that history belongs in your submission.
We consolidate out-of-network claims across all your facilities, flag the ones eligible for IDR, batch qualifying claims, complete open negotiation, and file through the CMS portal on time. We build each offer around your documentation and manage the arbitration to payment.
Which hospital-based services count as “ancillary”?
The No Surprises Act names emergency medicine, anesthesiology, pathology, radiology, neonatology, assistant surgeons, hospitalists, and intensivists, plus diagnostic services such as lab work and imaging.
Our group covers hospitals in more than one state. Does that matter?
It can. Many states run their own arbitration for plans they regulate, while self-funded employer plans generally use the federal process. LibeCore handles both state and federal processes and sorts each claim to the correct forum.
Do we have to negotiate before IDR?
Yes. Every claim goes through a 30-business-day open negotiation period first. We handle that negotiation for you.
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