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Independent Dispute Resolution (IDR) Service - BillWell

Ensuring Fairness and Transparency in Healthcare Billing Disputes

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Independent Dispute Resolution (IDR) Service - BillWell

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  1. Independent Dispute Resolution (IDR) Service Ensuring Fairness and Transparency in Healthcare Billing Disputes

  2. What is Independent Dispute Resolution (IDR)? • IDR = Independent Dispute Resolution • Neutral process for resolving billing/payment conflicts • Used primarily between providers and payers • Triggered when negotiations fail • Aims to remove the patient from the middle

  3. The Need for Independent Dispute Resolution • Rise in surprise billing cases • Out-of-network disputes common in emergencies • Patients often stuck with unexpected costs • Regulatory push (e.g., No Surprises Act - U.S.) • Growing demand for structured, tech-driven resolution tools

  4. How Does the IDR Process Work? • Dispute arises (usually around out-of-network payment) • 30-day open negotiation window • If unresolved, either party initiates IDR • Parties submit their final offers • Neutral reviewer selects one offer (baseball-style arbitration) • Decision is binding on both parties

  5. How BillWell Supports the IDR Ecosystem • Dispute Management Platform: End-to-end tracking of IDR cases • Automated Documentation: Ensure complete and timely submission • Analytics & Insights: Data-driven recommendations for submissions • Regulatory Compliance: Stay aligned with laws (e.g., NSA in the U.S.) • User-friendly Interface: For both providers and payers

  6. Benefits of IDR • Healthcare Providers: Fair reimbursement for services • Health Plans/Insurers: Structured process reduces friction • Patients: Protected from unexpected out-of-pocket costs • Regulators: Greater transparency and data traceability • BillWell Clients: Faster resolutions, fewer escalations

  7. Key Features of BillWell IDR Tools • Seamless case creation & tracking • In-platform communication & negotiation logs • Auto-validation for regulatory compliance • Integration with EHR and claim systems • Real-time status updates & alerts

  8. Real-World Impact • Provider disputed $4,500 out-of-network payment • Insurer offered $2,000 • Through BillWell.net, IDR process was initiated and tracked • Arbitrator selected provider’s $4,500 claim based on documentation • Time to resolution: 14 days • Patient responsibility: $0

  9. THANK YOU www.billwell.net

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