Digital. Dynamic. Dependable.
Simplify No Surprises Act Compliance by Accelerating Dispute Resolution
Manage the complete Independent Dispute Resolution lifecycle in a structured, automated, and auditable environment. From dispute intake and open negotiation to federal arbitration, payment compliance, case closure, and archival, the IDR Engine helps health plans stay ahead of regulatory deadlines
Built for Payers. Designed for Members
Leverage our Complaints, Appeals, & Grievances Suite to build trust with a member-first approach.
Automated SLA and Deadline Management
Calculate business-day timelines, monitor approaching deadlines, and trigger alerts and escalations
Unified IDR Case Management
Centralize case information, QPA documentation, offers, evidence, correspondence, decisions, and payment records
Open Negotiation Management
Manage offers, counteroffers, supporting documents, and the 30-business-day negotiation lifecycle
Arbitration Package Management
Validation of final offers, Qualifying Payment Amount (QPA) information, service records, and supporting evidence management for federal IDR submission
Automated Regulatory Correspondence
Generate acknowledgment, denial, negotiation, escalation, settlement, and payment-resolution communications at the appropriate stage
Payment Compliance Tracking
Calculate payment due dates, monitor obligations, flag overdue cases, and maintain proof-of-payment records
Audit-ready Case History
Maintain a complete, traceable record of actions, documents, communications, and decisions from intake through archival
Automated SLA and Deadline Management
Calculate business-day timelines, monitor approaching deadlines, and trigger alerts and escalations
Unified IDR Case Management
Centralize case information, QPA documentation, offers, evidence, correspondence, decisions, and payment records
Open Negotiation Management
Manage offers, counteroffers, supporting documents, and the 30-business-day negotiation lifecycle
Arbitration Package Management
Validation of final offers, Qualifying Payment Amount (QPA) information, service records, and supporting evidence management for federal IDR submission
Automated Regulatory Correspondence
Generate acknowledgment, denial, negotiation, escalation, settlement, and payment-resolution communications at the appropriate stage
Payment Compliance Tracking
Calculate payment due dates, monitor obligations, flag overdue cases, and maintain proof-of-payment records
Audit-ready Case History
Maintain a complete, traceable record of actions, documents, communications, and decisions from intake through archival
Learn What NewgenONE Independent Dispute Resolution Engine Can Do for You
End-to-end IDR Lifecycle Orchestration
Intake, acknowledgment, initial payment/denial review, open negotiation, federal arbitration, payment compliance, closure, and archival.
Real-time Visibility
Monitor dispute volumes, SLA adherence, approaching deadlines, workloads, and exceptions through role-based dashboards.
QPA and Supporting Documentation Management
Capture, organize, validate, and retain the information required to support dispute resolution and arbitration.
Role-based Collaboration
Provide tailored views for claims teams, compliance leaders, arbitration teams, providers, payers, and administrators.
Secure Provider and Payer Interaction
Support controlled submission of documents, negotiation information, and case-status tracking.
Low-code Configuration
Configure business rules, SLA thresholds, routing logic, and escalation paths to support changing operational and regulatory requirements.
Explore Other Solutions for the Payer-Provider Journey
Claims Automation
Streamline claims with an AI-driven, low-code automation process.
Provider Relations and Complaints
Enhance provider relationships while streamlining communications and driving a collaborative environment.
SIU & FWA Case Management
Detect and address fraud while enhancing efficiency and ensuring compliance.
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Request a demo to explore our solutions for the Payer-Provider Journey.
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