EPISODE · Jul 5, 2026 · 27 MIN
News You Can Use: Special Edition with Phia Part 3 of 6
from Healthcare NOW Radio Podcast Network - Discussions on healthcare including technology, innovation, policy, data security, telehealth and more. Visit HealthcareNOWRadio.com · host Healthcare NOW Radio and Podcast Network - Radio and Podcasts for the Healthcare Industry
Good Intentions, Unintended Consequences - Good Intentions, Unintended Consequences The No Surprises Act backfired, while it successfully eliminated surprise patient bills, Practices and Systems now game the Independent Dispute Resolution (IDR) process to get paid more than the original charges, sometimes double. The good news for patients, not so much as these costs are shifting to premiums, health plans are paying dramatically more, with claims over $1 million nearly doubling and industry arbitration win rates dropping below 10%. Hotspots of abuse exist, Nevada leads, and in Tennessee just 147 practices filed 36,000 disputes. Private equity-owned practices leading the way in turning arbitration into a business strategy. In an extension of the "No Surprises" we don't expect Congress to fix it. Medical facilities are often the largest employers in representatives' districts, creating a powerful conflict of interest. Solution include aggressive negotiation. Winning requires disciplined people-driven approaches during the 30-day negotiation window, identifying ineligible claims, and calling out bad actors. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
What this episode covers
Good Intentions, Unintended Consequences - Good Intentions, Unintended Consequences The No Surprises Act backfired, while it successfully eliminated surprise patient bills, Practices and Systems now game the Independent Dispute Resolution (IDR) process to get paid more than the original charges, sometimes double. The good news for patients, not so much as these costs are shifting to premiums, health plans are paying dramatically more, with claims over $1 million nearly doubling and industry arbitration win rates dropping below 10%. Hotspots of abuse exist, Nevada leads, and in Tennessee just 147 practices filed 36,000 disputes. Private equity-owned practices leading the way in turning arbitration into a business strategy. In an extension of the "No Surprises" we don't expect Congress to fix it. Medical facilities are often the largest employers in representatives' districts, creating a powerful conflict of interest. Solution include aggressive negotiation. Winning requires disciplined people-driven approaches during the 30-day negotiation window, identifying ineligible claims, and calling out bad actors. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
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News You Can Use: Special Edition with Phia Part 3 of 6
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