Out-of-Network Reimbursement
The payer
underpaid
There's a federal process for that
Teramed handles open negotiation and federal IDR end to end for out-of-network specialty practices. Your front desk forwards the claim. We manage routing, deadlines, and submission.
Why Choose Teramed Solutions
Automated workflows handle intake, data capture and deadline tracking, and our team handles the judgment calls. Claims move faster with less work for your staff.
Pre-Filing Eligibility Check
We determine whether your claims are actually IDR-eligible before you spend a dollar filing.
Automated Claims Intake
Remits and EOBs flow in through email, portal, SFTP or your billing system, and automation captures the data and starts every deadline clock the same day.
Maximum Recovery
Data-driven approaches that consistently achieve higher reimbursement rates.
Full Compliance
Complete adherence to federal regulations and No Surprises Act requirements.
Our Expertise
Comprehensive IDR Services
- 01 Complete dispute management and documentation
- 02 Expert negotiation with payers and arbitrators
- 03 Automated deadline tracking across every open claim
- 04 Real-time case tracking and transparent reporting
- 05 Strategic analytics to optimize future claims
"We handle the complexity so you can focus on care."
Transparent Pricing
Simple, Honest Pricing
You only pay when we succeed. No upfront costs, no hidden charges.
How We Charge
- Only on the increase. A competitive percentage of what we recover above the plan's original payment, never of what you'd already been paid.
- CMS & IDRE fees covered. We absorb all CMS and IDRE fees.
- Zero upfront. Nothing due until we secure your reimbursement.
Why It Works
Our success is tied directly to yours. We're motivated to maximize your recovery because we only profit when you win. It's a true partnership.
No Win, No Fee
If we lose, we cover all costs — including CMS and IDRE fees. You pay nothing. Your financial risk is zero.
What We Handle
Federal IDR Submission
Expert assistance with the federal Independent Dispute Resolution (IDR) process.
Learn moreState IDR Navigation
Guidance and support for state-specific Independent Dispute Resolution mechanisms.
Learn morePayment Integrity Audits
Proactive audits to identify and recover underpayments from payers.
Learn moreProvider Education & Training
Empowering providers with knowledge on billing, compliance, and dispute resolution.
Learn moreRegulatory Compliance Consulting
Ensuring your practice adheres to all relevant healthcare regulations and acts.
Learn moreProvider Guides
Understand the Process
Plain-English guides to the deadlines and rules that decide whether an out-of-network dispute succeeds. Or see how we handle it for you.
How to Handle Out-of-Network Underpayments
A step-by-step guide for providers: confirm the underpayment, find out which rules apply, fix coding issues, then use open negotiation and IDR to recover the rest.
Read the guideThe Federal IDR Timeline: Every No Surprises Act Deadline, Step by Step
Every deadline in the federal IDR process, from the payer's initial payment through open negotiation, IDR initiation, offers, determination and payment.
Read the guideIs Your Claim Eligible for Federal IDR? A Pre-Filing Checklist
Check these points before initiating federal IDR. The administrative fee is non-refundable, and ineligible disputes are one of the most common ways it's lost.
Read the guideReady to Optimize Your Revenue Cycle?
Partner with us to navigate the complexities of healthcare reimbursement and maximize your rightful compensation.