Services

White-glove IDR consulting.

Software alone doesn't win disputes — strategy does. PRISM's IDR specialists handle the entire arbitration lifecycle on your behalf, with results-based pricing.

White-Glove IDR Calculation

Hand-calculated, defensible IDR offers built around your case specifics.

  • Custom QPA challenge methodology
  • Geographic & specialty benchmarking
  • Outlier identification with credible info packets
  • Offer modeling against IDRE patterns
Open Negotiation Management

We run the entire 30-day Open Negotiation window so you don't have to.

  • Open Negotiation initiation
  • Payer follow-up & escalation
  • Settlement evaluation
  • Clean handoff to IDR if needed
Federal IDR Representation

Full-service representation through certified IDR entities.

  • IDRE selection strategy
  • Compliant initiation filing
  • Credible information assembly
  • Final offer submission & response
Appeals & Underpayment Recovery

Beyond NSA — ERISA, state surprise law, and contracted underpayments.

  • ERISA Level 1 & 2 appeals
  • State-specific dispute pathways
  • Contractual underpayment audits
  • Take-back & recoupment defense
Outsourced IDR Operations

Fully delegated IDR operations for groups without in-house bandwidth.

  • Dedicated case team
  • Weekly performance reporting
  • Payer-by-payer scorecards
  • Pay-on-results pricing
Training & Advisory

Build in-house IDR muscle with PRISM-led training and advisory.

  • NSA compliance workshops
  • QPA challenge bootcamps
  • Custom SOP development
  • Quarterly regulatory briefings
Engagement

How we work.

Most engagements start with a 30-day diagnostic. From there, we move to a pay-on-results retainer aligned to net recovery.

01
Discovery
We review a sample of EOBs and your payer mix under a signed BAA.
02
Strategy
Custom IDR playbook tied to your specialty, state, and largest payer counterparties.
03
Execution
PRISM team and platform handle Open Negotiation, IDR filings, and IDRE submissions.
04
Reporting
Weekly recovery reports and quarterly business reviews with your finance team.
Doctor in white coat and white gloves
Why white-glove

Specialists, not generalists.

Our IDR team is staffed by former payer auditors, healthcare attorneys, and actuarial analysts. Every dispute is owned by a named lead — not a queue.

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PRISM

Payment Resolution & IDR System Management. We help healthcare providers recover what they're owed under the No Surprises Act through proprietary software and white-glove IDR consulting.

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