By Adam Russo
A recent Health Affairs study underscores the challenges health plans face in the Independent Dispute Resolution (IDR) process, with a win rate of just 13.5%. In stark contrast, Phia clients benefit from a remarkable 53% success rate in IDR outcomes, including wins and dismissals.
Why is Phia outperforming others in the IDR space? Here are the key factors driving its success:
1. Timely Identification of Procedural Issues – Phia ensures procedural challenges are flagged and addressed without delay.
2. Regulatory and Billing Expertise – Phia adeptly identifies compliance and medical billing discrepancies, bolstering its clients’ cases.
3. Strict Timeline Adherence – Phia meticulously tracks and adheres to all IDR deadlines, ensuring no opportunities are missed.
4. Expert Collaboration – Attorneys, clinical coding staff, and case negotiators review past provider offers, refine evidence, and continuously strengthen arguments.
5. Good Faith Negotiations – Phia resolves many disputes even before a final IDR determination, demonstrating commitment to fair and efficient resolutions.
Phia’s proactive approach, deep expertise, and strategic execution translate into unparalleled results for its clients – which can be even more favorable if we are handling at the outset. When the stakes are high, Phia delivers.
Want to learn more about how Phia can support your organization? Reach out today to Garrick Hunt, Director of Business Development, at GHunt@phiagroup.com.
