Nearly half (48%)
of IDR awards won by emergency-medicine groups in 2025 were not paid within 30 days.
Source: EDPMA survey of 9 member organisations (659,600 won claims), April 2026.
New
The federal IDR administrative fee is now $15 per side (since June 11, 2026)
Insurers owe you money. We go after it.
Rivius files your federal No Surprises Act disputes, chases every award insurers haven’t paid, and appeals denied claims. You pay 12% of the extra money we recover, and only once it reaches your account.
No upfront fee to us, no long-term contract, cancel any time. Federal dispute fees are passed through at cost.
- Built on public CMS data
- No sales call
- Email answers within one business day
$15
is the federal administrative fee each side pays per dispute started on or after June 11, 2026. It was $115.
Source: CMS notice, 2026-06-03.
Many small practices don’t file at all.
Three organisations accounted for over three-quarters of the dispute lines resolved in 2025.
Source: Georgetown CHIR, 2026-08-28.
3 steps
How it works
Step 1
See your numbers.
Enter your NPI. We show your practice’s results from public CMS dispute data: your resolved disputes, how often you won, and how your awards compare with the top filer on the same codes. No patient data and no sign-up needed.
Step 2
Connect your remittances.
Sign the agreement and the HIPAA business associate agreement online, then upload your 835 or EOB files or connect your clearinghouse. Your biller keeps billing. Nothing gets re-enrolled.
Step 3
We file, chase and report. Insurers pay you directly.
We send open-negotiation notices, batch and file eligible claims, follow every award until it is paid or escalated, and appeal denials. Insurers pay you directly. We invoice 12% of the extra amount that arrived.
What we do
File, chase, appeal.
01 · IDR filing
IDR filing, only where it’s worth it.
We file only where the expected award clearly beats the federal fees. We batch similar claims into one dispute where the rules allow (up to 50 per dispute for negotiations starting on or after November 1, 2026) and set each offer from your own payer history.
02 · Unpaid awards
Unpaid awards, chased and escalated.
We track the 30-calendar-day payment deadline on every award, send reminders, and prepare complaints for the right regulator: the federal No Surprises Help Desk (CMS), the Department of Labor for self-funded employer plans, or your state insurance regulator for insured plans. That includes awards you won on your own.
03 · Denials
Denied claims, appealed.
We sort denials into quick corrections and real appeals, and file them before the deadline.
Dashboard
See every claim, every dollar, every delay.
A live view of your out-of-network money, plus a weekly email with what changed.
Awarded vs. paidSample data
Every award matched against your remittances, showing what was won and what actually arrived.
| Batch | Awarded | Arrived |
|---|---|---|
| B-1987Insurer B | $14,960 | $14,960 |
| B-1971Insurer C | $9,840 | $0 |
| B-2027Insurer A | $4,120 | due 10/24 |
Unpaid awards by insurerSample data
How late each insurer is, and our next step with its date.
-
Insurer C
41 days lateNext: regulator complaint · 10/02
-
Insurer A
12 days lateNext: second reminder · 09/30
-
Insurer D
4 days lateNext: reminder · 10/01
Outcomes with reasonsSample data
Won, lost or not filed, with the reason for every claim we didn’t file.
- Won 94
- Lost 18
- Not filed 23
Not filed · reason
- Expected award below fees14
- State process applies6
- Patient consented to out-of-network billing3
Insurer scorecardSample data
Days to pay, win rate and amount above the QPA, per insurer.
| Insurer | Days to pay | Win rate | Above QPA |
|---|---|---|---|
| Insurer A | 24 | 81% | +$2,140 |
| Insurer B | 19 | 88% | +$2,660 |
| Insurer C | 52 | 76% | +$1,730 |
Comparison
Rivius vs. other IDR vendors’ terms
| Rivius | Other IDR vendors (terms we reviewed) | |
|---|---|---|
| Fee | Rivius12% of money collected; federal fees passed through at cost | Other IDR vendorsOften 16–25% of money collected; some vendors pay the federal fees for you |
| Contract | RiviusMonth to month, cancel any time | Other IDR vendorsSome require multi-year exclusive contracts |
| After you cancel | RiviusWe finish disputes already filed and charge only on those | Other IDR vendorsSome contracts keep charging on every claim the vendor worked on, whenever it is paid |
| Getting started | RiviusOnline, no sales call | Other IDR vendorsUsually a sales call and a demo |
Based on published vendor terms, public SEC filings and practice reports reviewed in September 2026. Terms vary by vendor.
Pricing
12% of what we recover. That’s our whole fee.
Federal dispute fees are separate and passed through at cost.
Our fee
12%of what we recover
- No setup fee
- No minimum
- No exclusivity
- Month to month
Included
- IDR filing and batching
- Unpaid-award follow-up
- Denial appeals
- Dashboard and weekly report
When you cancel
We finish disputes already filed and invoice 12% only on those. Everything else is yours, and you can export your data at any time.
How we bill
Only on money that arrives, matched to your remittance line by line.
Federal fees (pass-through, paid from your account)
- The $15 federal administrative fee is charged to each side per dispute and is non-refundable (disputes started on or after June 11, 2026).
- The arbiter’s (IDR entity) fee is paid by both sides upfront. In 2026 it is $425–$800 for a single dispute and $625–$1,150 for a batch of up to 25 claims, plus $90–$250 for each further 25, depending on the arbiter. The winner’s fee is refunded within 30 business days. In a batch, the side that wins fewer claims pays, and a tie splits the fee.
Sources: 45 CFR 149.510 and Federal Register 2026-11140 (fees, refunds); CMS list of certified IDR entities, 2026 fees, updated 2026-08-31.
Security
How we handle your practice’s data
A US company.
Rivius Health is a US company. Our team, our systems and your data are all in the United States.
Your data stays in the US.
Stored encrypted in US data centres, with a HIPAA business associate agreement with our cloud provider.
The BAA is readable before you sign.
No offshore billing teams.
We don’t hand your files to outsourced offshore staff.
Disputes are submitted by an identity-verified team member
who is physically in the US, as CMS’s new IDR Gateway requires, under your written authorisation.
Insured.
Errors & omissions and cyber cover.
We never touch your money.
Insurers pay you directly. We only invoice our fee.
A note from Rivius
Out-of-network practices win most federal disputes, yet many awards are paid late or not at all. Many small practices never file, because it isn’t worth a staff member’s week. We built Rivius to do that work for a share of what actually arrives, with no lock-in to escape.
If you have a question, email us at support@riviushealth.com. We answer within one business day.
Sources: Georgetown CHIR, 2026-08-28; EDPMA survey of 9 member organisations, April 2026.
Frequently asked questions
Can’t find your answer? Email support@riviushealth.com.
Do I need a call to get started?
No. You can sign up online. We answer questions by email within one business day, and we’re happy to do a short call if you’d like one.
How long until money arrives?
A new claim goes through 30 business days of open negotiation, one to three weeks to start the dispute and confirm an arbiter, up to 30 business days for the decision, and then the insurer has 30 calendar days to pay.
If every party meets every deadline, that adds up to roughly four to five months from the first notice to payment. Insurers often pay late, so plan for longer. Awards you’ve already won can be chased right away.
We already use a vendor, or we’re under contract.
Check your contract first. Some IDR contracts are exclusive. We never ask you to break a contract. Denial appeals and awards you filed yourself may fall outside those terms; your contract decides.
Who submits the disputes?
An identity-verified member of our team who is physically in the US submits through CMS’s IDR Gateway on your behalf, under your written authorisation.
What does it cost if we lose?
Our fee is zero. You still pay the $15 federal administrative fee, and if the arbiter picks the insurer’s offer you also pay the arbiter’s fee ($425–$800 for a single dispute in 2026, more for a batch). That’s why we only file when the expected award clearly beats that cost.
What data do you need?
Your remittances (835 files or EOBs). For appeals we may ask for specific records. We never contact your patients.
Can I cancel?
Any time. We finish disputes already filed and charge only on those.
Does federal IDR apply to my claims?
It covers three kinds of out-of-network care for patients with job-based or individual health plans (not Medicare or Medicaid): emergency care; care by out-of-network clinicians at in-network hospitals and surgery centres, unless the patient validly agreed to out-of-network billing; and air ambulance. Where a state law sets the payment, the state process applies instead. We check the route for every claim before filing.
Do you use AI?
Yes, to read remittances, check eligibility and prepare filings. A person reviews every submission.
See what your practice may be leaving with insurers.
or email us at support@riviushealth.com