Meaningful out-of-network underpayments
Designed for claims where the potential recovery justifies specialized pursuit.
IDR execution for provider teams
Pursue eligible underpayments without adding IDR work to your team.
Provider Recovery Partners manages the dispute process from initial eligibility review through outcome tracking—while your team stays informed.
Federal IDR New York New Jersey Florida Texas
What PRP manages
01Eligibility review
02Open negotiation
03IDR initiation
04Evidence preparation
05Negotiation and tracking
Four standard claim documents plus one-time practice and provider onboarding information.End-to-end IDR execution
Claim-level dashboard visibility
Contingent recovery model
Who we help
Built for claims worth pursuing.
PRP works with individual providers and provider groups that need focused IDR execution without building another internal operating function.
Four standard claim documents
Insurance card, provider EOB or RA, CMS-1500, and operative notes, exchanged through secure intake.
Federal or supported state process
Potentially eligible federal matters and applicable disputes in NY, NJ, FL, and TX.
Claim-value and volume minimums apply. PRP confirms fit during the initial review.
How it works
You provide the records.
We carry the process.
Identify the right pathway
We review claim and payment information to determine whether federal IDR or a supported state process may apply.
Open negotiation
PRP initiates and manages the required negotiation period and keeps the case moving.
Prepare the dispute
We organize the required submission and turn client-supplied documentation into a clear evidence package.
File and negotiate
PRP manages filing, deadlines, communications, and negotiation throughout the applicable process.
Track the outcome
The dashboard keeps status, actions, outcomes, and incremental recovery visible to your team.
Standard claim intake
For most claims, four documents are enough.
Send the standard claim file through the secure onboarding workflow. PRP will organize it for eligibility review, negotiation, and dispute preparation.
01Patient insurance card
02Provider EOB or RA
03CMS-1500
04Operative notes
Practice and provider profile
Before the first matters are submitted, PRP will collect basic practice and provider information, including a provider CV.
Unusual casesAdditional documentation may occasionally be required. PRP will identify the specific item when the claim calls for it.
Secure exchange onlyThese materials may contain PHI. Never send patient information through the public website or scheduling flow.
Claim-level visibility
Know where every case stands.
The client dashboard makes stage, deadlines, actions, outcomes, and recovery reporting visible without pulling your staff into day-to-day administration.
ClaimPathwayStageLatest activity
PRP–2481FederalOpen negotiationPayer response logged
PRP–2537New YorkEvidence preparationDocumentation organized
PRP–2604TexasOutcome trackingPayment status monitored
Illustrative claim data. Live client views reflect actual matters.Aligned commercial model
Contingent on incremental recovery.
Incremental recovery
The amount ultimately paid
minus the amount originally paid.
Current coverage
Federal IDR plus four supported state pathways.
Federal independent dispute resolution
Potentially eligible matters under the federal process.
New York
Applicable disputes under the supported state pathway.
New Jersey
Applicable disputes under the supported state pathway.
Florida
Applicable disputes under the supported state pathway.
Texas
Applicable disputes under the supported state pathway.
Eligibility depends on the specific claim, plan, date, venue, and other facts. PRP confirms the available pathway before work begins. Review the coverage guide.
Frequently asked questions
What teams usually want to know first.
PRP is designed for potentially eligible out-of-network claims with meaningful underpayment opportunity. Federal or supported state eligibility depends on the specific claim facts, and claim-value and volume minimums apply.
For a standard claim, PRP needs the patient insurance card, provider EOB or RA, CMS-1500, and operative notes. At startup, we also collect practice and provider information, including a provider CV. Unusual cases may require additional documentation, which PRP will identify specifically. Sensitive records are exchanged through the secure onboarding workflow, never through the public website or scheduling flow.
PRP supports the federal IDR process and applicable state processes in New York, New Jersey, Florida, and Texas.
The commercial model is a contingent percentage of incremental recovery. Incremental recovery means the amount ultimately paid minus the amount originally paid.
Clients receive dashboard visibility into claim status, deadlines, actions, outcomes, and recovery reporting.
Start without sharing PHI
See whether the opportunity is ready for manual review.
Use the browser-only preparation check, then schedule a conversation with high-level information about your organization and claim opportunity.