CollectionPro, a specialist in Independent Dispute Resolution (IDR) and out-of-network (OON) collections, has announced an expansion of its recovery services tailored for complex medical specialties such as surgical, orthopedic, and interventional pain practices. With the No Surprises Act (NSA) continuing to challenge the financial stability of these providers, CollectionPro offers a zero-risk pathway to recover fair market value for specialized medical services.
Since the implementation of the NSA, healthcare managers have faced increased administrative complexity, with routine billing departments often struggling with the technical nuances of the IDR process. CollectionPro focuses exclusively on out-of-network claims, providing legal and analytical scrutiny for each case. Under the leadership of David Nissanoff, the firm has handled over 10,000 cases, maintaining a 92% win rate—significantly higher than the industry average—by utilizing proprietary data and specialty-specific arguments that counter unfair payer benchmarks.
“The No Surprises Act was intended to protect patients, but it should not be used by insurers to systematically underpay specialized providers,” said Nissanoff. “At CollectionPro, we act as the legal and operational backbone for practices. We ensure that if you are out-of-network, you are still compensated for the true value of your expertise.”
A primary hurdle for healthcare managers in the IDR process is the high cost of entry, with traditional vendors often requiring upfront arbitration and administrative fees that can exceed $1,200 per dispute. CollectionPro eliminates these fees by operating on a pure contingency-based model: the firm fronts all administrative and arbitration costs, and physicians pay only a 10% success fee based on the gross award if they win. This performance-only structure aligns CollectionPro’s goals with those of the healthcare provider, turning a costly administrative burden into a predictable revenue stream.
CollectionPro assists providers by identifying specific CPT codes and facility settings—primarily places of service 21, 22, 23, and 24—that qualify for maximum recovery. Key differentiators include customized pricing strategies that move beyond basic Medicare multiples, jurisdictional expertise navigating federal NSA rules and state-specific laws (such as those in New Jersey and California) with in-house state-licensed lawyers, and aggressive enforcement against insurers that fail to pay won awards, including CMS reporting and legal follow-up.
Through a secure, user-friendly portal, practices have complete transparency regarding Explanation of Benefits (EOB) and patient details. Once OON claims are submitted, CollectionPro manages the entire dispute lifecycle—from claim analysis and open negotiation during the mandatory 30-day window to arbitration management and live tracking via an integrated dashboard. The firm also specializes in recovering highly aged receivables, often re-opening and re-filing out-of-network claims that are 12 to 36 months old, allowing practices to capture funds previously considered write-offs.
