IDR Case Examples

How IDR Works in Practice

Illustrative examples of how practices use IDR to recover out-of-network revenue, organized by specialty.

FIND YOUR SPECIALTY

A different practice.
The same need for clarity.

Select a specialty to explore its example, then open the full story.

ILLUSTRATIVE CASE · 01 / 07Houston, TX

Recovered $2.3M in underpaid claims

How a network of freestanding ERs built a systematic IDR program to recover revenue from out-of-network emergency services.

$2.3MExample recovery
94%Example win rate
12 monthsReporting period
Explore the freestanding emergency room story

An anonymized, composite example. These figures illustrate a scenario and are not verified customer results or a forecast for your practice.

THE INDUSTRY CONTEXT · REPORTED HISTORICAL DATA

3.3M+

IDR disputes filed

mid-2022 to May 2025

85%

Provider win rate

2024 industry data

$2.24B

Paid to providers above QPA

2023–2024

3.7×

Median IDR vs. Medicare

across all specialties

Sources: Georgetown CHIR (May 2025), Brookings (Adler & Fiedler, March 2024). These are industry-wide IDR process metrics, not Clearest-specific results.

Illustrative Examples by Specialty

Walkthroughs of how the IDR process works across different specialties. Anonymized and composited from typical engagements.

7 examples
ER

Recovered $2.3M in underpaid claims

How a network of freestanding ERs built a systematic IDR program to recover revenue from out-of-network emergency services.

$2.3M

Recovered

94%

Win Rate

12 months

Timeline

AG

Increased collections by 38%

Strategic IDR filing for high-volume anesthesia practices with complex payer contracts and systematic underpayment.

$1.8M

Recovered

91%

Win Rate

9 months

Timeline

AA

Recovered $4.1M in disputed claims

Navigating complex balance billing regulations with cost-based evidence and air ambulance-specific benchmark data.

$4.1M

Recovered

89%

Win Rate

14 months

Timeline

IONM

Recovered $1.9M from systematic denials

Fighting medical necessity denials with clinical evidence and surgical society guidelines.

$1.9M

Recovered

87%

Win Rate

11 months

Timeline

RS

Recovered $890K in reconstructive cases

Distinguishing medically necessary reconstruction from elective procedures with clinical evidence.

$890K

Recovered

92%

Win Rate

10 months

Timeline

SS

Recovered $3.2M in complex cases

Maximizing reimbursement for multi-level fusion procedures with implant cost documentation.

$3.2M

Recovered

91%

Win Rate

15 months

Timeline

BS

Recovered $1.4M in coverage denials

Overcoming coverage denials and underpayment for weight loss surgery with medical necessity evidence.

$1.4M

Recovered

85%

Win Rate

12 months

Timeline

What Made the Difference

Common factors across successful practices

Verified Benchmarks

Real payment data

Strategic Selection

Winnable cases only

Full Documentation

Nothing left to chance

Deadline Management

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