CollectionPro Services LLC today highlighted its comprehensive out-of-network revenue recovery services for hospital facilities with underpaid or denied claims. The company helps hospitals assess disputed facility payments, determine whether claims qualify for the federal Independent Dispute Resolution (IDR) process, negotiate with payers, prepare and manage eligible disputes, and pursue payment after a determination.
For hospital finance leaders, an out-of-network claim can remain unresolved even after a payer has issued an initial payment. The facility may need to establish whether the claim was processed correctly, understand the payer’s stated reason for its payment decision, gather records supporting the amount in dispute, and act within the applicable negotiation or filing deadlines. CollectionPro’s services are designed to bring those tasks into a single recovery process for the facility’s receivable. The review also helps teams identify accounts requiring immediate attention before an appeal or dispute deadline closes.
CollectionPro’s approach calls for a clear record of what the hospital billed, what the payer paid, and why the remaining balance is disputed. The company reviews the account before selecting a recovery route, because a claim correction, payer appeal, direct negotiation, or federal IDR case may each be appropriate under different circumstances.
“A hospital should be able to see exactly why an out-of-network facility claim was underpaid and what can be done next,” said David Nissanoff, the spokesperson of CollectionPro. “Our team handles the work from claim evaluation and payer negotiation through an eligible IDR case and follow-up on the award. The goal is to turn a disputed balance into a resolved account.”
CollectionPro’s hospital-focused review begins with the facility claim and its remittance. The team examines the services billed, payer payment or denial, available clinical and claim documentation, prior correspondence, and any unresolved accounts receivable activity. It identifies the facility as the billing party and keeps its claim separate from professional claims submitted by physicians or other clinicians involved in the same encounter.
That distinction can be particularly important in emergency care. A hospital’s facility charge and the professional charges of an emergency physician, anesthesiologist, or other clinician may be associated with one episode of care but represent separate payment disputes. CollectionPro evaluates the hospital’s own claim, supporting documentation, and available recovery options rather than treating all related balances as one case.
When an eligible facility claim falls within federal IDR, CollectionPro supports the process from the outset. Its specialists assess the claim and the applicable dispute pathway, review payer information, and manage the required 30-business-day open negotiation period. If negotiation does not resolve the payment amount, the team helps prepare the IDR initiation, organize relevant evidence, manage case communications, and track the dispute through the certified IDR entity’s determination. That coordination helps the hospital keep its payment position, clinical support, and filing record together throughout the case.
Evidence preparation is a central part of that service. Depending on the facts and applicable rules, documentation may address the clinical circumstances of the encounter, patient acuity, case complexity, facility characteristics, and other permitted information relevant to the payment offers. CollectionPro works with the hospital’s records and claim details to present a consistent account of the disputed facility payment.
The company also advances applicable federal administrative and IDR entity fees under its service arrangement for many specialties. This support allows hospital teams to discuss the costs and responsibilities of a potential dispute as part of the engagement instead of treating filing logistics as an afterthought.
An IDR award is not the end of the recovery process. CollectionPro tracks the payer’s payment following a determination, follows up on unresolved amounts, and provides reporting on the status of the account. That post-award work is intended to help hospitals establish whether an award has resulted in payment and whether the facility receivable can be reconciled and closed. It also gives the finance team a way to distinguish a successful determination from money actually received, an important difference when forecasting collections and deciding which balances still need payer attention.
CollectionPro also supports hospitals when federal IDR is unavailable. Not every out-of-network facility claim qualifies: the service, coverage, network circumstances, and applicable state payment rules all matter. A disputed claim may instead call for payer follow-up, an available appeal, or another collection route. By reviewing eligibility before filing, the company helps facilities direct their effort toward the process that applies to the account.
This approach is particularly relevant to hospitals managing a mix of emergency claims, aging out-of-network receivables, and multiple commercial payers. Each account may be at a different stage: awaiting an initial response, eligible for open negotiation, approaching an IDR filing window, pending a determination, or awaiting payment after an award. CollectionPro says its customized reporting helps hospital teams see where each claim stands and what action remains.
CollectionPro’s announcement places the emphasis on the full life of a facility claim. Its work begins with understanding the payer’s response and continues through the appropriate dispute or recovery route until the payment outcome is documented. For hospitals, that means IDR support is connected to the original underpayment and the final collection, rather than handled as a separate filing task. The company invites facilities to bring forward both recent disputes and older unresolved accounts for an assessment of the options still available.
Hospital facilities seeking to evaluate denied or underpaid out-of-network claims can request a review at collectionpro.com or contact CollectionPro at [email protected].