The recoverable money your insurer is counting on you to ignore.
When an out-of-network claim comes back underpaid, you don't have to accept it. The federal dispute process exists to make insurers pay fairly — and it works. Most practices just never use it.
New to out-of-network arbitration? Start with the plain-English basics →
What out-of-network arbitration actually is.
When you treat a patient out-of-network (OON), the insurer decides what to pay — and it's often far less than your claim. The federal No Surprises Act (NSA) created a process to settle that gap fairly: Independent Dispute Resolution, or IDR.
IDR is a form of arbitration. You submit the amount you should be paid; the insurer submits theirs. A neutral arbitrator picks one. There's no splitting the difference — which is exactly why preparation and specialty knowledge decide the outcome.
OON — out-of-network. Care delivered without a contract with the patient's insurer.
NSA — the No Surprises Act, the federal law that protects patients and created the dispute process.
IDR — Independent Dispute Resolution, the arbitration step that decides the payment.
QPA — Qualifying Payment Amount, the insurer's benchmark rate. Arbitration awards routinely land several times higher.
State laws — many states (including New York and Florida) have their own surprise-billing and dispute processes that run alongside the federal one.
The numbers favor providers — by a lot.
Industry-wide and practice-level figures shown as context. Outcomes vary by claim; this is not a guarantee of recovery.
You hire one team. We run the whole recovery.
Most people picture arbitration as a single filing. It isn't. The filing is the last step of a months-long process — and that process is where Divitiae does its work.
We find what's worth fighting
We review your out-of-network claims, pull the ones that are underpaid and qualify, and tell you straight which are worth pursuing.
We push the insurer
We become the liaison, work the negotiation cycle, and track every claim and payout. You always know where each case stands.
We take it to arbitration
When a claim reaches the formal IDR filing, our specialist arbitration partner handles that step. We stay your single point of contact through the award and the recovery.
In practice, Divitiae owns roughly 80% of the work it takes to recover the money — the intake, the insurer contact, the case tracking, the management. We bring in a specialist partner only for the formal filing itself. To you, it's one team and one point of contact, start to finish.
We also pursue recovery through the right process for each claim — the federal No Surprises Act and applicable state programs, including New York's mandatory dispute resolution and Florida's provider–health plan program. A claim that doesn't qualify federally may still be recoverable under state law. Knowing which road a claim belongs on is part of the work.
Clinical fluency is the moat.
We've been in the room
Our practice is led by an operating-room insider with three decades in plastic and reconstructive surgery. The clinical context behind a claim isn't a guess — it's lived knowledge that goes straight into the appeal.
Specialty depth, not volume
The large arbitration shops serve hospital groups and staffing platforms. They aren't built for a three-surgeon plastic practice or a solo podiatrist. We are.
One continuity, end to end
The same people who understand the procedure understand the coding, the denial, and the dispute. Nothing gets lost in a handoff between strangers.
Honest about the odds
We tell you which claims are worth fighting and which aren't. You won't pay us to chase money that isn't there.
Before you ask.
Do I have to leave my current billing company?
No. Arbitration is a separate service. Many practices keep their existing billing in place and bring us in specifically to recover underpaid out-of-network claims.
What does it cost?
Recovery work is structured so it's worth your while — we'll walk you through it on a free claim review. The point of the conversation is the money you stand to recover, not a fee schedule.
Which specialties do you work with?
Plastic and reconstructive surgery, orthopedics, and podiatry — the specialties where out-of-network dynamics and per-claim recovery are strongest.
Who actually handles the arbitration filing?
Divitiae runs the full recovery process and stays your single point of contact. For the formal IDR filing step, we work with a specialist arbitration partner. You deal with one team throughout.
Is patient data involved up front?
No. A free claim review starts with high-level information only — no patient-level claim data is needed to tell you whether there's an opportunity worth pursuing.