H Halkovich Law Attorneys at Law
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Primary service

No Surprises Act arbitration for providers that need more than routine filing support.

Halkovich Law helps healthcare providers and facilities pursue payment through the federal IDR process when eligible out-of-network claims are underpaid after open negotiation.

Federal IDR strategy Provider-side only Nationwide representation
Direct answers

What is NSA arbitration?

No Surprises Act arbitration is the federal independent dispute resolution process used to resolve certain out-of-network payment disputes between healthcare providers and health plans. After open negotiation, each side submits a payment position to a certified IDR entity, which selects the appropriate payment amount under the applicable rules.

What is the IDR process?

The IDR process generally starts after an eligible payment dispute goes through open negotiation. If negotiation does not resolve the dispute, a party may initiate IDR, address eligibility and batching issues, submit a payment offer with supporting information, and receive a determination from the certified IDR entity.

When should a provider file an IDR dispute?

A provider should consider filing when the claim appears eligible, the open negotiation period has ended or is ending, the amount at issue supports escalation, and the provider can meet timing and documentation requirements. Eligibility and deadlines should be reviewed carefully before filing.

NSA arbitration vs payer appeals: what is the difference?

Payer appeals usually challenge coverage, coding, medical necessity, or plan processing decisions within the payer's administrative system. NSA arbitration is a federal payment dispute process for eligible out-of-network claims after open negotiation. The correct route depends on the claim type, law, plan, and deadline.

Learn how IDR arbitration works or see when to file an IDR dispute.

Why providers lose value in IDR

The opportunity under the No Surprises Act is real, but so are the procedural traps. Providers often lose leverage because the claim set is not screened carefully, the timing is not controlled tightly, or the final-offer presentation is too thin to carry the dispute.

Where insurers push the hardest

  • Procedural objections aimed at eligibility, coding, timing, or batching
  • QPA-heavy positions presented as if they are the only relevant payment benchmark
  • Delay that pressures providers into low-value outcomes before the dispute matures
  • Submissions that exploit incomplete provider framing or weak supporting records

Who this practice is built for

Physicians, hospital-based groups, ASCs, imaging centers, emergency-related providers, and facilities pursuing payment for eligible out-of-network services.

How Halkovich Law approaches NSA matters

  • Review claim sets for eligibility, timing, and economic viability
  • Audit fee schedules to evaluate whether billing practices may be leaving reimbursement opportunities unresolved
  • Structure open negotiation and IDR strategy around recoverable value
  • Prepare stronger submission records with payment logic and supporting detail
  • Coordinate portfolio-level strategy when disputes repeat against the same plans

IDR vs litigation

IDR is a specialized arbitration process for eligible No Surprises Act payment disputes. Litigation is broader and may address contract claims, ERISA issues, payer conduct, audit disputes, or matters outside the IDR process. Some provider portfolios require both procedural analysis and litigation strategy.

Next move

Use the Revenue Recovery Review before valuable IDR opportunities age out.

The review form helps surface whether your NSA matters belong in immediate review, how they fit alongside other dispute categories, and what an attorney should evaluate first.

Request Review Read the IDR guide

Frequently asked questions

What is No Surprises Act arbitration?
It is the federal independent dispute resolution process used to resolve eligible out-of-network payment disputes when negotiation does not produce agreement.
Who can use the IDR process?
Eligibility depends on claim type, service setting, timing, and federal law. A focused claim review is the best way to determine whether the process applies.
Can you review a large portfolio of claims?
Yes. Portfolio-level strategy is often where legal value is highest because batching, economics, and payer patterns matter more than one isolated claim.
How long does NSA arbitration take?
Timing depends on claim eligibility, payer objections, batching, documentation, and the IDR entity process. Providers should review deadlines early because timing errors can affect dispute rights.
What documents are needed for IDR?
Useful documents may include EOBs, open negotiation records, claim data, payer correspondence, payment history, service information, and support for the provider's payment position.
Is IDR always better than litigation?
No. IDR is useful for eligible NSA payment disputes, but litigation or another dispute route may be more appropriate for contract, ERISA, or broader payer conduct issues.
Provider action

Evaluate the claims before NSA leverage disappears.

If your organization is carrying IDR-eligible disputes, start with the audit or request direct attorney review now.

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