For billing companies and RCM firms
Filing federal IDR across more than one client practice?
IDR is one of the last major revenue functions still handled largely by hand: eligibility screening, batch construction, deadline tracking, and submission assembly, all done claim by claim. That labor intensity is why most RCM firms either decline the work or price it painfully. Sydra supplies the automation layer underneath it, so you can open or expand an IDR service line without adding headcount in proportion to volume.
It can run white label under your own brand. Your clients see your service, not ours.
Built on Claude via Amazon Bedrock · Built to support HIPAA safeguards · BAA on request · ModMed and Stedi integrations · SOC 2 aligned, report under NDA · Security details

88%
Source: Georgetown University CHIR, March 2026
5 minutes
~10%
Source: ACEP analysis of CMS data
The volume problem is different when it's not your practice.
A single practice's billing team can absorb 25 to 40 minutes per manual IDR submission because the volume is bounded by one practice's claims. A billing company or RCM firm doesn't have that ceiling. The volume is the sum of every client practice's eligible claims, and it grows every time you sign a new client.
At that scale, the 25 to 40 minute manual build time isn't a staffing inconvenience. It is the reason claims across your whole book go unfiled.
The fee math
What recovery looks like at your volume.
Drag the sliders to match a client practice or your book. The estimate uses published CMS win rates and Georgetown CHIR award benchmarks, not a Sydra performance claim.
Uses the CMS published 88% win rate on the amount already in dispute. Award multiples versus QPA are not applied here. Recovery is capped at the disputed amount. Not a Sydra performance claim.
Estimated annual recovery
$3,168,000
Per month
$264,000
Typical contingency cost
$633,600/yr
You keep it with Sydra.
That's $3,168,000 a year you're currently writing off.
Want that number verified against a real claim instead of an estimate? Send us one denied EOB and we'll tell you exactly what it's worth.
What stays separate, client by client.
Sydra prepares a specialty coded federal IDR submission in about five minutes, with tenant isolation built in at the data layer so each client's claims, documents, and history stay separate.
Sydra's tenant isolation is enforced at multiple layers, not just a permissions toggle: application logic, API authorization, database row level security, and audit logging all scope to the individual practice's tenant identifier. For a firm handling several clients' PHI under separate BAAs, that separation is the part that has to be structurally true, not just promised in a contract.
- Each practice's claims, documents, and submission history stay within that practice's tenant.
- Audit logs capture user, timestamp to the second, action, record affected, and IP address, available to the account administrator on request.
- A Business Associate Agreement is available for every covered entity and business associate using Sydra to process PHI, executed during contracting.
Full details: Sydra security and HIPAA controls.
One claim per CPT by default, across every client practice.
Sydra defaults to one claim per CPT, because filing individually generally protects win rate when high value codes would otherwise share one arbiter offer. Batching is CMS sanctioned as of the 2026 rule and available when your team chooses it for a specific submission. That discipline matters more, not less, at billing company scale: the more claims moving through your team every week, the more an unexamined batch decision compounds across every client's disputes.
Sydra's specialty coding covers orthopedics, neurosurgery, spine, plastics, anesthesia, and general surgery, at the same depth whether you bring one practice or ten.
Pricing that scales with volume, not a per seat model.
Sydra doesn't publish list pricing because the right structure depends on specialty mix, state mix, and monthly out of network volume, all of which look different for a billing company aggregating several clients than for a single practice. Pricing is per claim or subscription, never a percentage of recovery, so your cost stops scaling against you as your book grows.
On the call, bring your actual client volume and specialty mix and get a real number instead of a generic estimate that doesn't reflect how your book is built.
Book the call from here.
Fifteen minutes on your own book: how many client practices carry out of network volume, and what an IDR service line would add without new headcount. Nothing to sign.
Free 15-minute call. No commitment. Bring a real claim from any specialty in your book and we'll show you what Sydra generates, and talk through how the account structure fits a multi client firm.
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Also see billing company FAQs, running IDR in house, and Compare your IDR options.
Questions billing companies ask first
Can Sydra handle IDR for more than one practice at once?
Do you offer a firm wide dashboard across all our client practices?
Is pricing different for a billing company than for a single practice?
Does Sydra replace our clearinghouse or EMR integrations across multiple client systems?
Do you still take a percentage of recovery at billing company volume?
Sourced references
- 1. CMS Federal IDR Q1/Q2 2025 Public Use FileReleased January 21, 2026cms.gov/nosurprises/policies-and-resources/reports
- 2. CMS Federal IDR Q4 2025 Public Use FileQuarter 4, 2025. Source for the per CPT area average initial payment and median figures in the Practice A table on the homepage. Geography and median denominator are pending confirmation from ops; see the TODO above PRACTICE_A in src/lib/content/homepage.ts.cms.gov/nosurprises/policies-and-resources/reports
- 3. Sydra client records, presented with client permissionProvenance for the Sydra performance figures in SYDRA_PERFORMANCE (src/lib/idr/proof-points.ts): 92% across 113 decided cases, 82.9% across 76 decided cases under the client's prior contingency firm, and the CPT 19318 award of $50,742.00 against a $2,500 QPA. Decided cases only; excludes withdrawn, ineligible, and pending disputes. Not federal data and not a category benchmark.
- 4. Georgetown University CHIR · Health Affairs webinarMarch 2026. 3.4 million disputes through June 2025; 88% win rate; median award ~4.5x in network rate
- 5. Zelis: NSA IDR Eligibility ChallengesMarch 2026. 44% of 2024 IDR cases challenged as ineligible by non initiating party
- 6. ACEP analysis of CMS data~10% of eligible claims estimated to reach IDR arbitration
- 7. Brookings Institution NSA Arbitration DatabookApril 2026brookings.edu/articles/no-surprises-act-arbitration-databook
- 8. ACR: Providers Prevail in Vast Majority of IDR ClaimsJanuary 2026. 88% of disputes found in provider's favor; 87% of awards exceeded QPA
- 9. No Surprises Act: Public Law 116-260, Division BB, Title I
- 10. Federal IDR regulations: 45 CFR Part 149ecfr.gov/current/title-45/subtitle-A/subchapter-F/part-149
- 11. CMS No Surprises Act overviewcms.gov/nosurprises
- 12. HHS HIPAA for professionalshhs.gov/hipaa/for-professionals
- 13. CMS Final Rule: No Surprises Act IDR overhaul (HHS, DOL, Treasury, OPM)Administrative fee reduced from $115 to $15. Batching of multiple claims now permitted to lower costs and speed resolution. New IDR Gateway centralized platform rolling out in phases.cms.gov/newsroom/press-releases/federal-rule-takes-aim-saving-taxpayer-dollars-health-care-bureaucracy-reducing-dispute-fees

Book a demo
Free 15-minute call. No commitment. Bring a real claim from any specialty in your book and we'll show you what Sydra generates, and talk through how the account structure fits a multi client firm.
Or email sales@sydrahealth.com with a question.