Radix Health is now Pivotal Health
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FOR eMERGENCY MEDICINE GROUPS
IDR done right
Secure fair reimbursement for out-of-network emergency care with an AI-powered Independent Dispute Resolution (IDR) platform built for compliance, transparency, and scale.
Get your free IDR assessment

82%

win rate

95%

success rate

5x

initial payment

Trusted by leading emergency medicine groups nationwide

The No Surprises Act created uncertainty in reimbursement

Emergency medicine groups can’t cut their hours when reimbursement falls. They have to staff the next shift and be ready for whoever comes through the door. Yet out-of-network payments have fallen precipitously in recent years.

That makes IDR a critical way to recover fair reimbursement and keep those shifts covered. But with the process under growing scrutiny, how it’s used matters more than ever.

37.7%

drop in out-of-network emergency physician payments from 2019 to 2022, steepest in the year the No Surprises Act took effect1

IDR done right protects revenue and the process
The wrong way
Eligibility is a checkbox: A quick call based on what the payor reports, which lets ineligible claims through and misses ones that belong.
Offers built to maximize: Choose a number based on the award it might win, not the care it represents, with little evidence to support it.
Driven by manual work: Rely on teams of people to track deadlines and manage disputes, making compliant execution harder as volume grows.
Wins that put IDR at risk: Every shortcut and unsupported offer gives critics reasons to challenge the process and push for blunt reforms.
The Pivotal way
Eligibility is an investigation: Research claims beyond the payor's data, and let every eligibility ruling inform how the next one is screened.
Offers built to hold up: Use market data, contract history and clinical records to build evidence-based cases for fair reimbursement.
Driven by technology: Give every dispute a consistent, automated workflow with built-in deadline tracking and compliance checks.
Wins that keep IDR viable: Every well-run dispute shows the process working as intended and helps preserve it for providers who need it.

Your path to fair reimbursement wih Pivotal

1. CONNECT YOUR CLAIMS

Share your full claims feed through your billing system or RCM partner. Pivotal already integrates with Logix Health, Ventra Health, Zotec and more.

2. FIND WHAT QUALIFIES

Our proprietary eligibility engine applies federal and state IDR rules to identify eligible claims and route them to the right arbitration process.

3. TAKE IDR OFF YOUR PLATE

We run IDR end-to-end, handling open negotiations, batching, offer strategy, and every deadline, with your risk preferences and guardrails built in.

4. TRACK YOUR PROGRESS

See where every dispute and dollar stands, and how your IDR program is performing, through a real-time analytics and financial management portal.

See what emergency medicine leaders say

“Pivotal Health has provided us, a small local business, with the tools and support to drive our practice forward and recoup the reimbursement that we deserve for the expert care that we provide.”

Timothy Chilcote, MD

President

President Kansas Emergency Physicians

“Pivotal Health has proven to be a great partner. The service team have been useful resources, and we have had immediate success.”

Kim Campbell

Practice Manager

Williamsburg EP

More reasons to choose Pivotal
100% focused on IDR
IDR is all we do, so you stay ahead of every rule change with a partner who knows the process inside and out.
Up and running in 30 days
Fast, seamless deployment with minimal ongoing maintenance, plus no impelementation or integration fees.
Built on better data
Contract history, market data, and clinical records, combined into evidence-backed cases to prove fair payment.
Paid only when you are
Some vendors collect fees as soon as arbitration is won. Pivotal earns only when awarded payments hit your account.
True scale & automation
Technology touches every eligible claim and keeps compliance consistent, no matter how much volume you have.
Committed to sustainable IDR
Beyond your disputes, we advocate for targeted fixes that keep IDR viable for emergency medicine groups.
Get your free IDR assessment
Send us a sample of your claims data, and we’ll show you where eligible claims may be missed or under-recovered, at no cost and with no obligation.
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Citation: [1] U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, No Surprises Act Third Report to Congress (February 2026).

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