Sydan Health specializes in healthcare dispute resolution and independent review services associated with the Federal Independent Dispute Resolution (IDR) process established under the No Surprises Act.

The Federal IDR process provides a mechanism for resolving payment disputes between providers, facilities, air ambulance services, and health plans when agreement cannot be reached regarding reimbursement for certain out-of-network services. Patients are not parties to these disputes.

Sydan Health brings direct experience supporting review activities associated with the Federal IDR process, including participation in the review and determination of more than 600 disputes involving:

• Emergency services

• Non-emergency services provided by out-of-network providers at in-network facilities

• Air ambulance services

Experience includes review activities involving both single disputes and batched or bundled disputes, with adherence to established timelines, documentation standards, and review requirements.

Sydan Health applies an objective and evidence-based approach to healthcare dispute review. Review activities may include evaluation of:

• Clinical documentation and medical records

• Relevant billing and reimbursement information

• Applicable statutory and regulatory factors

• Supporting documentation submitted by disputing parties

• Relevant standards, policies, and review criteria

Sydan Health maintains policies and procedures designed to support impartial review activities and conflict-of-interest management.

Our organization is committed to:

• Independent and objective review

• Fair and consistent evaluation processes

• Evidence-based decision-making

• Protection of confidential information

• Compliance with applicable regulatory requirements

• Independent Medical Review (IMR)

• Independent Review Organization (IRO) Services

• Utilization Review and Medical Necessity Review

• Healthcare Compliance Review

• Independent Healthcare Review Services