Champ AI
Healthcare automation

No Surprises Act Federal IDR operations

Recover eligible out-of-network revenue before the window closes.

Champ moves qualified disputes through open negotiation and Federal IDR, assembles the required evidence, tracks every filing window, and reconciles the final payment while your team approves consequential offers and exceptions.

HIPAA-ready Managed by Champ Self-healing

Federal IDR recovery queue

Every dispute, deadline, and payment outcome

Live
Work itemStatus
01

Applicability review

Federal and state process path checked

Qualified
02

Open negotiation

Notice delivered and response window tracked

Running
03

IDR submission

Offer and supporting evidence assembled

Ready
04

Payment follow-through

Determination matched to remittance

Tracking

EXECUTION

Continuous

EVIDENCE

Every step

OWNER

Champ

Every window

tracked by dispute

One case

from negotiation to payment

Approval

for consequential offers

The operational bottleneck

The federal process is defined. The operational work is still fragmented.

Teams must determine whether a dispute belongs in the federal process, preserve evidence across multiple stages, act inside short filing windows, and verify that the determination actually reaches the payment record.

Bring us your workflow
01

Federal, state, and all-payer processes can apply differently based on coverage and jurisdiction

02

The 30-business-day open negotiation period is followed by a four-business-day IDR initiation window

03

Claim, remittance, communication, and supporting evidence live across separate systems

04

A favorable determination does not complete the workflow until payment is reconciled

The production workflow

One continuous operation, not another disconnected tool.

Champ coordinates browser, document, API, voice, and human steps around the outcome your team is responsible for.

  1. 01
    Identify and qualify the dispute

    Read the claim and remittance, check coverage and jurisdiction facts, and route unclear applicability questions for review.

  2. 02
    Run open negotiation

    Prepare the notice, deliver it through the approved channel, preserve proof, and monitor the full negotiation period.

  3. 03
    Initiate Federal IDR

    Assemble claim data, offers, attestations, and supporting materials for an authorized reviewer before submission.

  4. 04
    Reconcile the outcome

    Track entity selection and determination, compare the result with remittance and payment, and escalate underpayments or missing funds.

Why it stays reliable

Built around the work, not a brittle integration map.

Your systems can stay exactly where they are. Champ operates across them, records what happened, and improves the workflow as the process changes.

Applicability with evidence
Apply approved federal-versus-state routing logic while preserving the plan, jurisdiction, service, and timeline facts behind the result.
Deadline-native execution
Turn notices and stage changes into controlled timers, required actions, and escalations before a filing window is at risk.
Recovery through payment
Keep the dispute open beyond submission so determinations, remittances, and actual payments resolve in one case.

Works with your stack

If your team can access it, Champ can work in it.

Use APIs where they are dependable and managed browser agents everywhere else. No rip-and-replace required.

Federal IDR portalPractice-management systemsRCM platformsClearinghouses835 remittance dataPayer portalsDocument repositoriesShared inboxes

Change the operating model

Give your team exceptions, not another queue to babysit.

Manual operation
More volume becomes more repetitive work.
  • Teams reconstruct eligibility from claim and plan details
  • Short filing windows are tracked in spreadsheets and inboxes
  • Evidence packets are assembled separately at every stage
  • Determinations and final payments are reconciled by hand
Recommended
Operated by Champ
More volume becomes more completed outcomes.
  • Approved applicability logic produces a source-backed case path
  • Every deadline creates the next action and escalation automatically
  • Claim data, notices, offers, and evidence remain in one record
  • The workflow continues until the payment outcome is confirmed

More healthcare workflows

One platform across the back office.

Insurance eligibility & benefits verification
Champ verifies commercial, Medicare, Medicaid, and Medi-Cal coverage across every required source, then completes the plan-specific work that a standard eligibility response leaves behind, including benefits, authorization requirements, and ECM qualification.
Provider credentialing & enrollment
Champ keeps provider profiles complete, submits enrollments across payer portals, follows every application, and sends only true exceptions to your credentialing team.
Referral intake & submission automation
Champ reads incoming referrals, validates the packet, creates the patient record, submits through the required portal or fax channel, and follows every case until it is accepted or needs review.

No Surprises Act Federal IDR operations FAQ

Questions healthcare operators ask first.

You have more questions?

Send us an email

Do the work of fifty
without hiring one more.

Eligibility
Verification
Claims
Payroll
Carrier check-in
Patient intake
Benefits
Credentialing
Credentialing