Post-Award Collection & Enforcement

CollectionPro > Post-Award Collection & Enforcement

Turn Your Federal IDR Award Into Actual Payment

Winning a federal IDR determination is an important step, but it does not automatically place the awarded amount in your account. Payers must still process the determination, adjust the remittance, and issue payment within the applicable federal payment window.

CollectionPro helps providers move from award to cash by tracking unpaid or underpaid federal IDR determinations, reconciling remittances against the awarded amount, identifying discrepancies, and following up with payers until payment is verified.

Won Your IDR Case But Still Haven’t Been Paid?

A favorable determination can still be followed by delayed payment, partial payment, or no payment at all. The federal payment deadline is 30 calendar days after the determination, yet post-award payment issues can leave significant reimbursement outstanding.

CollectionPro provides dedicated post-award support for providers that need structured payment tracking, award-to-cash reconciliation, payer follow-up, and escalation. We can also review certain unpaid or underpaid awards won through another IDR vendor, subject to the documentation available and applicable terms.

Services We Offer

Post-Award Recovery at a Glance

From federal payment deadlines to contingency-based recovery, CollectionPro helps providers move favorable IDR determinations
toward verified payment.

30
Calendar Days
Federal Payment Deadline
Post-Award Payment
Tracking
10,000+
OON Cases
Handled
Award-to-Cash
Reconciliation
$0
Upfront Cost
For Award Review
Payer Follow-Up &
Escalation
10%
As Low As
Recovery Fee
Contingency-Based
Pricing

WINNING IS JUST THE FIRST STEP

Why Federal IDR Awards Can Remain Unpaid

Post-award payment problems often occur after the arbitration itself is complete. Understanding where the process has stalled helps determine the right follow-up and escalation strategy.

01
Claim Processed at QPA, Not the Award
The payer processes the claim at the original qualifying payment amount instead of re-adjudicating it to reflect the IDR-determined amount.
02
Internal Administrative Backlogs
Awarded claims can remain in payer processing queues when no structured post-award follow-up or escalation is initiated.
03
Remittance Mismatches
A partial payment may be issued without clearly addressing the remaining balance, leaving the provider underpaid even after receiving a remittance.
04
Handoff Gaps From Prior Vendors
Determinations won through another billing company or IDR vendor may remain uncollected when there is no dedicated post-award tracking process.

KNOW THE WARNING SIGNS

6 Signs Your IDR Award May Be Unpaid or Underpaid

No payment has been received within 30 calendar days of the determination
The remittance amount is lower than the IDR-awarded figure.
The EOB was processed at the original QPA rather than the award amount.
The determination was won through a prior vendor, but payment was never collected.
The award is several months old with no confirmed full payment on file.
No remittance advice was issued after the determination.

THE NEXT STEP

What CollectionPro Does After the Determination

Our post-IDR recovery process is designed to keep a favorable determination active until the payment is properly reconciled and the outstanding balance is resolved.

Post-Award Payment Tracking
Determinations are logged and monitored against the 30-calendar-day federal payment window from the date of issue.
Award-to-Payment Reconciliation
Payments received are compared with the IDR determination to verify that the correct awarded amount was applied.
Underpayment Identification
QPA-versus-award discrepancies are identified and documented when remittance does not match the determination.
Payer Follow-Up & Escalation
Structured payer outreach begins when the payment window passes without confirmed receipt of the full award amount.
A/R Reconciliation After IDR
Accounts receivable is reconciled following award collection so the final balance accurately reflects the determination and payment received.
Tailored Award Status Reporting
Customized reporting provides visibility into outstanding balances, payment status, follow-up activity, and recovery progress.

END-TO-END RECOVERY

The Full IDR Recovery Lifecycle

Winning the award is Step 7. CollectionPro supports the complete reimbursement process beyond the determination so the outcome can move toward verified payment.

STEP 01
Identify Claim
STEP 02
Analyze & Evaluate
STEP 03
Open Negotiation
STEP 04
File IDR
STEP 05
Build Evidence
STEP 06
Arbitration
STEP 07
Win Award
STEP 08
Pursue Payer Payment
STEP 09
Reconcile & Verify
STEP 10
Revenue Recovered
Many vendors may stop at the award. CollectionPro continues through payer payment, reconciliation, and verified recovery.

RECOVERY FOR PROVIDERS

Unpaid IDR Award Recovery for a Wide Range of Providers

Providers with favorable federal IDR determinations that have not been paid in full may be eligible for post-award recovery support. CollectionPro works with individual practitioners, group practices, skilled nursing facilities, hospitals, and other healthcare facilities managing outstanding out-of-network awards.

Physicians & Specialists (MD)
Individual practitioners and specialists with unpaid or underpaid IDR determinations on out-of-network claims.
Group Practices (GP)
Multi-provider groups managing multiple outstanding awards across different payers and plan types.
Skilled Nursing Facilities (SNF)
Facilities with post-acute OON determinations where payment has been delayed or issued below the awarded amount.
Hospitals & Facilities (HSP)
Hospital systems with facility or ancillary IDR determinations requiring post-award payment reconciliation.

Awards Won Through Another IDR Vendor? We Can Review Them Too.

Your practice does not need to have used CollectionPro from the beginning of the IDR process. If another billing company or IDR vendor obtained the determination but the payer has not paid in full, CollectionPro may be able to review the outstanding balance and help pursue recovery.

Eligibility depends on the documentation available, the age of the determination, and the payer’s remittance history. Not every situation will have a viable recovery path, but a no-cost review can help determine whether options may remain.

BEFORE YOU SUBMIT

What to Have Ready for an Unpaid Award Review

  • IDR Determination – The binding decision issued by the certified federal IDR entity.
  • Award Amount – The full dollar amount determined by the arbitrator.
  • Payer Name and Plan Type – The insurer involved and whether the plan is self-funded or fully insured.
  • Date of Determination – The date the IDR entity issued the binding decision.

  • Payment or EOB Received – Any remittance advice or explanation of benefits issued after the determination.
  • Date Payment Was Received – If a payment was issued, even if it was partial or incorrect.
  • Payer Correspondence – Any written communication with the payer after the determination.

General RCM Follow-Up vs. Dedicated Post-IDR Recovery

A favorable determination should not simply be marked closed. Dedicated post-IDR recovery keeps the case active until the payment is verified against the amount awarded.

INTERNAL / GENERAL RCM TEAMS
COLLECTIONPRO POST-IDR RECOVERY
Win Logged as Closed
Determination Tracked to Confirmed Payment
QPA-vs-Award Mismatches Missed
Award-to-Remittance Reconciliation
No Clear Escalation Pathway
Structured Payer Follow-Up & Escalation
Third-Party Won Awards Left Behind
Third-Party Award Review Available

TRUSTED FOR RECOVERY

Why Providers Choose CollectionPro

92% IDR Win Rate   |   10,000+ Arbitrations Filed   |   $0 Admin & Arbitration Fees Charged   |   Recovery Fee Up to 10%   |   Aged Claims May Be Considered

No Upfront Cost
The award review and follow-up process are provided at no cost to the practice. A contingency fee applies only if a recovery is made.
Third-Party Award Review
Unpaid or underpaid determinations won through another IDR vendor may be reviewed, subject to documentation and applicable terms.
Older Award Recovery Considered
Older outstanding determinations can be reviewed to assess whether a recovery pathway may still exist based on available documentation.
Tailored, Transparent Reporting
Customized reports keep your team informed about outstanding balances, payment status, follow-up activity, and recovery progress.
Full OON Reimbursement Coverage
CollectionPro supports providers across the out-of-network reimbursement lifecycle, from claim identification through post-award payment verification.
No Binding Contracts
Engagements operate on a contingency basis, with no long-term contract required to begin a review or pursue qualifying outstanding award balances.
AWARDED. NOW GET PAID

Request a Free Post-IDR Award Review

If you have a favorable IDR determination that has not been paid in full, or the remittance does not match the awarded amount, let CollectionPro review the outstanding balance at no cost.

We will assess the documentation available and help determine what post-award recovery options may be applicable. Review requests may also be submitted for awards won through a previous IDR vendor where payer payment remains outstanding.

REQUEST A FREE REVIEW

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