Michael chats with Max Mangum, Co-founder and CEO of Pivotal Health. Together, they discuss the purpose of the Independent Dispute Resolution (IDR) process under the No Surprises Act and why it was created to help ensure fair out-of-network reimbursement; the administrative and reimbursement challenges providers face when trying to participate in IDR; how growing administrative complexity is limiting provider access to the process; the impact of CMS's updated IDR rules on transparency, efficiency, provider reimbursement and eligibility; the role of AI and human expertise in reducing administrative burden and supporting compliant reimbursement workflows; and what it will take to ensure IDR remains a fair, efficient, and sustainable process for providers, payers, and patients.
Learn more about Pivotal Health at www.pivotalhealth.ai.
