Surprise Medical Billing

Kepro is certified by the Centers for Medicare and Medicaid Services (CMS) to serve as an independent dispute resolution entity (IDRE), or third-party arbiter, in the IDR process established by the No Surprises Act (NSA). The Act created new federal safeguards as of January 2022 against surprise medical bills that arise when consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose. When a provider or facility and a health plan can’t agree on the payment amount for an out-of-network service experienced by a patient, they are now able to initiate the new federal independent dispute resolution process using an approved arbiter like Kepro. Over the past 6 years, we have completed thousands of IDR reviews for surprise medical billing.

Our more than 35 years of experience in healthcare and the deep experience of our independent medical reviews business unit, IMEDECS,  allows us to bring our extensive knowledge, capabilities and our strong bench of experts to every case we manage.  Through our medical review program, we have more than 3,000 independent, board-certified medical experts and certified professional coders who are dedicated to quality health care and improved clinical outcomes – successfully resolving thousands of cases to date with care, consistency, medical expertise and non-bias.