The Economics of the No Surprises Act: Why 90% of Eligible Claims Are Being Left on the Table

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The No Surprises Act (NSA) reshaped the landscape of reimbursement. Patients are now shielded from unexpected out-of-network bills, but providers face a new challenge: securing fair payment from payers. To address this, Congress created Independent Dispute Resolution (IDR) — an arbitration mechanism designed to resolve disputes between providers and insurers. IDR offers providers the ability to secure fairer reimbursement, often several times higher than the initial payer offer. Yet most providers are not taking advantage. Only about 10% of eligible claims are pursued through IDR. That means 90% of claims — billions of dollars in potential revenue — are left on the table each year.

This white paper explores the economics of underutilizing IDR, quantifies the revenue impact, and provides a framework for providers to build IDR into their revenue cycle strategy.