Our work in Independent Dispute Resolution (IDR)

Nine CMS remark codes turn a payer's Federal IDR eligibility call into a written statement on every out-of-network line. The code is quick to look up; the decision behind it is where the build effort goes.

A payer's map of the new Federal IDR requirements: what lands in November, what lands in January, what waits on the IDR Gateway, and where the real burden falls.

Trexin's own SaaS platform manages the federal IDR process under the No Surprises Act end to end, built on a solution already proven in production at a healthcare payer.

Facing roughly 12,000 dispute emails a month under the No Surprises Act, a health insurer asked Trexin to overhaul IDR processing. The withdrawal process alone saved about $100k a month, and win rates climbed as high as 32%.

A data-driven look at IDR offer strategy under the No Surprises Act, why the long-standing 1:1 offer-to-QPA playbook is losing ground, based on the 2023 CMS dispute data, and how payers should adapt.