The Out-of-Network Provider's Arbitration Readiness Guide

What's Inside — 10 Chapters

• 01
  NY IDR vs. Federal NSA — Which Applies to Your Claims

  The single most important question before you do anything else
• 02
  The Aged Claim Recovery Window — Identifying Recoverable Claims

  How to audit your claim history for NY state IDR eligibility
• 03
  Pre-Arbitration Documentation Checklist

  8 things every practice must have in place before filing any dispute
• 04
  The Credible Information Framework

  What arbitrators actually look for — and how to give it to them
• 05
  Specialty-Specific Tips

  Anesthesiologists, plastic surgeons, radiologists, and ASCs
• 06
  How to Read Your EOB and Identify IDR-Eligible Underpayments

  Translating insurer Explanation of Benefits into dispute opportunities
• 07
  Using FAIR Health — The NY IDR Advantage

  How to pull and use FAIR Health 80th percentile data
• 08
  The Baseball-Style Offer Strategy

  How to calibrate your demand to win — not lose — arbitration
• 09
  Breast Reduction OON — A Case Study

  Documentation strategy for CPT 19318 medically necessary reductions
• 10
  Common Mistakes That Cause Providers to Lose IDR Cases

  The 7 most common errors and how to avoid them