Quick Summary
Major Changes Coming to the Federal IDR Process
Healthcare providers utilizing the federal Independent Dispute Resolution (IDR) process under the No Surprises Act will soon see significant changes aimed at improving efficiency and reducing administrative burdens. On May 28, 2026, the Departments of Health and Human Services, Labor, and Treasury, along with CMS, finalized new rules that overhaul key aspects of the federal IDR process.
Perhaps the most notable change is the reduction of the administrative fee from $115 to just $15 per party per dispute. The more than 85% decrease dramatically changes the economics of pursuing reimbursement disputes, particularly for providers managing large volumes of lower-dollar claims.
For anesthesia groups, ambulatory surgery centers (ASCs), and other specialty providers, the lower fee may make it financially practical to challenge underpayments that previously may not have justified the cost of arbitration.
Addressing Longstanding IDR Challenges
Since its launch in 2022, the federal IDR system has received more than five million disputes, far exceeding initial government projections and creating substantial processing backlogs.
Industry leaders have welcomed the latest reforms, which are designed to streamline the process and reduce administrative obstacles. Updated regulations provide clearer guidance regarding open negotiations, dispute eligibility, and information exchange between parties. Federal officials have stated that the changes are intended to improve transparency while reducing delays throughout the arbitration process.
Another important update involves expanded batching flexibility. Under the new rules, providers will have greater ability to combine similar claims into a single dispute while maintaining reasonable limits on batch size.
This change addresses a major concern among high-volume specialties. Under previous interpretations, providers were often forced to file thousands of separate disputes for similar claims, significantly increasing administrative costs and delaying resolution.
Improved Transparency and Technology
The new rule also introduces standardized claim coding requirements for payers when communicating about out-of-network services. These requirements should help providers identify qualifying IDR claims earlier in the process and reduce confusion during dispute initiation.
In addition, a centralized IDR gateway platform will begin rolling out in phases starting in 2026. The system will allow users to initiate disputes, monitor case status, and manage activity through a single platform. As implementation progresses, payers will be required to register within the system, making it easier for providers to identify the appropriate parties and avoid administrative errors.
Enforcement Concerns Remain
While providers generally view the new rules as a positive step, significant concerns remain regarding enforcement of arbitration awards. Recent court decisions have determined that providers do not have a private right of action under the No Surprises Act to enforce unpaid IDR determinations.
As a result, even providers who prevail in arbitration may still encounter delays in collecting payment. Several healthcare organizations continue to advocate for additional legislative reforms that would strengthen enforcement mechanisms and hold payers accountable for unpaid awards.
What This Means for Healthcare Providers
The reduced filing fee and expanded batching flexibility may significantly improve providers’ ability to challenge underpayments through the IDR process. Healthcare organizations that previously avoided arbitration due to cost concerns may now have additional opportunities to pursue reimbursement recovery.
Providers should also prepare for upcoming operational changes, including the use of standardized claim codes and the eventual transition to the centralized IDR platform.
How Patriot Group Can Help
As reimbursement disputes continue to evolve under the No Surprises Act, healthcare providers need experienced guidance to maximize recovery opportunities while maintaining compliance. Patriot Group works with healthcare organizations to identify underpaid claims, navigate the IDR process, strengthen revenue recovery efforts, and address payer-related challenges.
Our team helps providers evaluate dispute strategies, improve reimbursement outcomes, and stay ahead of regulatory changes that may impact financial performance. If your organization has questions about IDR disputes, payer underpayments, or revenue recovery opportunities, Patriot Group is available to help.
Thomas J. Force, Jr.Vice President of Patient Accounts
A graduate of Arizona State University, having received his Bachelor of Arts in Civil Economic Thought and Leadership, Thomas quickly integrated into The Patriot Group shortly after graduating and has brought a fresh perspective to company strategies and protocols, particularly with regard to patient collections.
Currently, as the Vice President of Patient Accounts, Thomas heads up the company’s Patient Accounts Department and is responsible for overseeing staff and ensuring that patients have a clear understanding of their financial obligations, are treated with respect, and ultimately make payments to further boost our clients’ revenue.
Jennifer ManiaciVice President of Coding
Jennifer is a professional coder certified by the AAPC with over 25 years of experience in medical office settings. She is responsible for overseeing any and all coding issues and is tasked with managing the most complex accounts – namely those concerning highly-specialized out-of-network surgeons who often rely upon unlisted codes in order to bill for their services. In this regard, Jennifer regularly secures GAP exceptions for our clients’ patients (i.e., allowing for in-network benefits for out-of-network services) and negotiates lucrative single case agreements to ensure our clients are afforded substantial compensation for their highly-skilled services.
As part of her responsibilities, Jennifer takes great pride in advocating for patients against payors so that our clients’ patients can rest assured that they will receive the maximum benefits from their plan.
Meredith MonteleoneVice President of Operations
Meredith has worked in the healthcare industry for the past 25 years, having managed all areas of the revenue cycle. Her expertise runs the full gamut of revenue cycle matters, including serving in- and out-of-network parties, professional and facility clients, and clients involved in an abundance of practice areas (e.g., vascular, orthopedic, ENT, general practice/primary care, chiropractic, and surgical).
With her extensive experience, which also includes teaching classes at Hunter Business School since 2004, Meredith is responsible for managing accounts, supervising staff, delegating assignments, and analyzing accounts to ensure our clients revenue is maximized.
Susan O’Connor-Van WinckelVice President of Administration
With more than a decade of experience, Susan is integral to the success of The Patriot Group and its clients. A professional coder certified by the AAPC, and having past entrepreneurial experience, Susan certainly understands the importance of maintaining an efficient and profitable revenue cycle.
With this mindset, Susan serves as the ultimate team player. Aside from being primarily responsible for account implementation and general account management, based on Susan’s expertise, she regularly steps up to address the most complex revenue cycle issues, namely those faced by new clients whose past billing company left their account in shambles.
Farooq WaheedChief Technology Officer
A dedicated entrepreneur, Farooq has actively founded, and participated in the start-up of, several successful health-related organizations, including Patriot International Group, the entity that handles aged receivable collection for The Patriot Group.
Prior to engaging in his entrepreneurial endeavors, Farooq served as a senior software developer with Applied Sciences Group. In this capacity, Farooq designed, developed, and maintained highly scalable software and web applications. With this experience, Farooq, along with his brother Rauf Waheed, has been integral in developing software to promote a more efficient aged receivable collection process that separates The Patriot Group from its competitors. As a result, our clients benefit from the maximum collection on their aged receivables.
Rauf WaheedChief Technology Officer
Much like his brother, Rauf is a serial entrepreneur with substantial experience founding, launching, and scaling businesses primarily rooted in the healthcare sector. Relying on his nearly 15 years of experience serving in high-level strategy and planning roles with Fortune 500 companies such as IBM and CenturyLink, Rauf brings an analytical expertise to The Patriot Group that far exceeds that of its competitors.
This skillset, coupled with his background in software engineering, enabled Rauf and his brother, Farooq, to develop and integrate software designed to promote increased and more efficient aged receivables collection. In applying this software to its aged receivable collections, The Patriot Group has been able to increase its clients’ revenues, while speeding up their revenue cycles.
Robert T. Neuner, Esq.General Counsel
An attorney licensed in New York, New Jersey, and Arizona, Robert has spent the vast majority of his professional career in the healthcare sector since graduating from Brooklyn Law School.
Prior to joining The Patriot Group at the start of 2021, Robert simultaneously served as General Counsel, Director of Mergers & Acquisitions, and as the interim Chief Financial Officer for a medical management services firm that subsequently developed into a sizeable primary care practice in Arizona. During this five-plus year tenure, Robert served as the right hand of that company’s owner and Chief Executive Officer. In this regard, Robert played an integral role in that organization’s exponential growth (its revenues multiplying ten-fold), while ensuring that the operations ran efficiently and compliantly.
Robert relies on this past experience, as well as his previous litigation experience, in order to promote the compliance of our clients. As part of his responsibilities, Robert defends against audits and recoupments/refund demands, provides guidance on carrier policies and applicable laws/regulations, appeals unpaid or underpaid claims, and represents clients in surprise billing disputes.
Michele ForceFounder & Chief Executive Officer
Michele Force has over 30 years of experience as a Senior Executive in Operations, Sales, and Customer Service for a West-Coast technology company with a focus on the insurance industry. She has worked with some of the largest insurance organizations in the country, developing extensive experience in technology infrastructure and techniques to increase client profitability. Mrs. Force has developed significant high-level contacts at various insurance companies and other insurance-related organizations.
As Chief Operating Officer, Mrs. Force manages day-to-day activities and client interface while spearheading technology initiatives within The Patriot Group. She is a polished and experienced senior executive, and her team strives to deeply understand clients' goals, problems, and needs. The better they understand the dynamics of their clients' practice, the better they can help them maximize revenue. Their goal is their clients' long-term success, and they aim to be a trusted, loyal partner who ensures they get the most dedicated and passionate team working for them.
Mrs. Force's focus on customer service and her expertise in the insurance industry have helped The Patriot Group build lasting relationships with their clients. Her dedication to maximizing revenue for clients has made her a valuable asset to the company.
Thomas J. Force, Esq.Founder & President
Thomas J. Force is an attorney with significant experience in the healthcare and insurance industries. Mr. Force's background as a former U.S. Marine, Wall Street insurance litigator, General Counsel, Chief Compliance Officer, and CEO of a revenue cycle company showcases a diverse and extensive career.
His expertise in healthcare revenue collection techniques, appeal strategies, and healthcare compliance makes him a valuable resource in the field. Additionally, his role on the Advisory Board at Hunter Business School, involvement with medical billing and coding students, and frequent speaking engagements at medical associations and healthcare organizations highlight his commitment to education and sharing knowledge in the industry.
Mr. Force focuses on a range of topics, including Effective Out-of-Network Work Flow, Successful Appeals Drafting, The Dangers of Waiving Patient Cost Share Responsibility, The No Surprise Act, and The Federal Anti-Kickback, Stark, False Claim Act, and HIPAA. In Short, Mr. Force has a comprehensive understanding of legal and compliance issues within the healthcare sector. His focus is protecting and defending the healthcare provider, and assisting with the generation of revenue for medical practices.