No Surprises Act Specialists
MD Claims files and manages federal Independent Dispute Resolution under the No Surprises Act for doctors, health systems, and staffing companies — end to end, with no fees upfront. And unlike anyone else in this market, we can give you money today for claims in arbitration.
We work every specialty the No Surprises Act touches — including emergency medicine, radiology, anesthesia, pathology, hospitalist and critical care, surgery, neonatology, and air ambulance — plus the staffing companies and health systems.
The Problem
Out-of-network claims do not collect themselves. Filing is technical, the clocks are unforgiving, and even a won dispute takes several months to pay.
Eligibility rules, a thirty-business-day negotiation window, entity selection, administrative fees, a position statement, and a single offer that decides everything. Claims go unfiled because nobody has the bandwidth — not because they wouldn't have won.
Independent Dispute Resolution runs on statutory clocks. Miss a date and the dispute is over regardless of merit — no appeal, no second filing, no matter how strong the case was.
Each side submits one offer and the arbitrator selects one in full — there is no splitting the difference. Determinations take several months, and if the insurer's offer is chosen the wait produces nothing beyond the benchmark rate you were already paid.
MD Claims runs the disputes end to end — and can take the waiting off your books entirely.
What We Do
Most providers come to us to run their disputes. Some also want the cash before the arbitrator rules — that part is optional and never changes how a case is run.
The service
End to end, from eligibility screening through to the wire. Your billing partner keeps its workflow — we run the dispute.
The part no one else offers
Once a dispute is filed it becomes an eligible receivable. If you would rather not wait several months, we can advance capital against it.
How It Works
Send us what you have in arbitration, or what you think might qualify. We will tell you which claims are worth filing before anyone commits to anything.
Eligibility review finds what qualifies for federal IDR and rules out what would be dismissed on a technicality. Filing a claim that cannot win still costs you the fee.
The thirty-business-day open negotiation window is worked before it closes. Filing, certified entity selection, and administrative fees are handled end to end.
A data-backed position statement built on benchmark rates, your clinical detail, and how comparable disputes have actually resolved.
Each side submits one number and the arbitrator selects one in full. Nothing else in the process moves the outcome as much.
Your related claims are batched together to keep administrative fees down.
The losing party must pay within thirty days of the determination. We follow it to the wire.
Money Today
Every other IDR firm files your disputes and leaves you waiting on the arbitrator.
Wired once the dispute is filed and priced. No waiting on the arbitrator's docket and no restrictions on how you use it.
No interest, no personal guarantee, no lien on the practice. It does not sit on your books as debt.
If the insurer's offer prevails the advance stays with you — no clawback, no repayment. That outcome risk moves to us at closing.
Take an advance on every claim, a few of them, or none at all — filing with us never requires it.
Use of Capital
If you take an advance, there are no restrictions on how you use the capital and no covenants attached to it. Here is where it typically goes.
Stop letting a slow arbitration queue dictate whether partner draws and clinician comp go out on schedule.
Signing bonuses, relocation, malpractice tail coverage, and the first ninety days of salary all land long before a new hire's billings collect.
Hospital coverage agreements and staffing awards require you to fund the ramp before the first remittance arrives.
Retire a revolver, a merchant cash advance, or an equipment note. Non-dilutive, non-recourse capital beats a 20% line of credit.
Batching and prosecuting disputes costs real money in fees and administrative time. Monetized claims let you pursue the next tranche instead of rationing it.
Better coding, eligibility, and denials infrastructure pays for itself — but only if you can afford it before the savings show up.
Imaging, ASC build-out, monitors, and IT are capital expenses that don't wait on an arbitrator's docket.
Convert a long-dated, uncertain receivable into cash ahead of a refinancing, a partner buy-in, or a sale process.
Recognize value for physician-owners now rather than asking them to wait on a determination that may be many months out.
The Structure
If you take an advance, this is what it is — and what it isn't. Capital against a receivable you already earned, not debt against your practice.
| MD Claims | Bank line of credit | Merchant cash advance | |
|---|---|---|---|
| Structure | Advance against a receivable | Debt | Debt |
| Personal guarantee | None | Usually required | Usually required |
| Lien on the practice | None | Typically all assets | Typically all assets |
| Interest | None | Accrues monthly | Effective rates often 30%+ |
| If the plan's offer prevails | You keep the advance and owe nothing back | Still owed in full | Still owed in full |
| Upfront fees | None | Origination and legal | Origination |
| Time to cash | About 10 days | Weeks to months | Days |
Who We Work With
Hospital-based and ancillary groups carrying disputed out-of-network volume: emergency medicine, radiology, anesthesiology, pathology, hospitalist and critical care, neonatology, and surgical specialties.
Facility and employed-physician claims that qualify for IDR but never get filed, and the ones already sitting in the queue where the gap between determination and cash distorts quarterly results.
Clinician staffing platforms and practice management groups that front payroll across many contracts and cannot afford to have working capital parked in a federal arbitration queue.
Air ambulance disputes are their own category under the Act, with their own rules, their own economics, and their own long tail. We file them and we fund them.
Questions
Both, and filing is the core service. We screen eligibility, work the negotiation window, file, select the IDR entity, build the position statement, set the offer, and follow the determination through to payment. Separately — and only if you want it — we can advance capital against claims already in arbitration.
No fees upfront. We are paid out of what we recover for you, so we have no reason to file a claim that cannot win. Terms are set against your portfolio and put in writing before you commit to anything.
No. The advance is optional on a claim-by-claim basis — take it on every claim, a few of them, or none at all. Filing with us never requires it, and it does not change how a case is run.
No. Federal IDR is an administrative process, not litigation — you do not need counsel to file or to win, and the firms that file the most disputes nationally are specialist IDR vendors, not law firms. MD Claims is not a law firm and does not provide legal advice. We prepare, submit, and prosecute the disputes. Where you already use counsel, we work alongside them.
Yes. Your billing partner keeps its workflow — nothing about your revenue cycle changes. Many groups bring us the disputes their current vendor is not filing, or hand over a specific tranche to see how it performs before moving more.
Out-of-network emergency and certain ancillary claims under the No Surprises Act. If you aren't sure which of your claims qualify, send the file — telling you what qualifies is the first thing we do, and it costs nothing.
No. Where you take an advance, MD Claims advances capital against the disputed portion of the award. There is no interest, no personal guarantee, and no lien on your practice. It does not appear as debt and it does not encumber your other receivables.
You keep the advance and owe nothing back. That outcome risk transfers to us at closing — it is the core of what you're getting.
Yes, in all cases. The qualifying payment amount the plan already paid you is yours and is never part of the advance. We look only at the disputed upside above it.
About ten days from submission to wire. The amount is specific to the claims — the procedure codes, the benchmark amounts, the offers submitted, and how comparable disputes have resolved. We put the number in writing before you commit to anything.
We look at portfolios across a wide range of sizes, from single-practice tranches to health-system and staffing-company volume. Tell us what you have and we'll tell you quickly whether it's a fit.
Nothing. There are no diligence, legal, closing, or servicing fees at any point in the process.
Get Started
Takes two minutes. No cost, no obligation, and nothing here commits you to anything. We respond within one business day.
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