Beyond the Win Rate: Rethinking How IDR Actually Works

The No Surprises Act's independent dispute resolution process has become a costly and complex operational challenge, and the arbitration win rate tells only part of the story. For health plans, the bigger question may be what happens before a dispute ever reaches a final determination. As IDR requirements evolve, documentation, eligibility decisions and day-to-day workflows can have significant implications for how efficiently disputes move through the process. In this episode of Healthcare Insider, host Sarah Loeffler talks with Maisie Weir, VP of Strategic Solutions at Zelis, about what payers should be watching as the IDR landscape changes and ways reducing administrative friction could benefit both sides of the payer-provider relationship. They'll also discuss implications of new Zelis-commissioned research. Listen to hear what a more effective approach to IDR could look like and where technology, process improvements and human expertise fit into the equation.