Radiology Associates of North Texas (RANT) has released an internal analysis projecting more than $51 million in avoidable administrative costs tied to current No Surprises Act arbitration batching rules and unpaid Independent Dispute Resolution (IDR) awards.
According to RANT, the group has prevailed in approximately 95% of finalized IDR disputes involving Blue Cross Blue Shield of Texas, yet more than $3.5 million in awarded balances remain unpaid, with nearly $1.64 million outstanding for more than 120 days.
RANT's analysis contends that current federal batching interpretations are sharply increasing administrative costs by forcing providers to divide similar claims into thousands of smaller arbitration filings. Under an ideal batching process, the group projects approximately 1,369 batches at a total administrative cost of $1.05 million. Under the current federal interpretation advocated by Blue Cross Blue Shield of Texas, that figure rises to approximately 68,450 batches and $52.7 million in administrative costs, according to RANT.
The issue gained urgency following a recent Fifth Circuit Court ruling holding that providers do not have a private right of action under the No Surprises Act to enforce unpaid IDR awards. RANT is calling on lawmakers to establish penalties for insurers that fail to comply with binding IDR payment determinations and to modernize Centers for Medicare and Medicaid Services (CMS) batching guidance.
