Your IDR report says you win 9 out of 10.That's not the number that pays you.
The groups with the best win rates recover the least money. Not slightly less. Three times less.
Recourse runs federal IDR for physician groups and optimizes every filing for dollars recovered, not headline win rate.
Get your free filing benchmark ↓
It runs backwards.
Sort every major filer into ten groups by win rate, and the groups winning most often are the ones collecting least.
Dollars recovered, by win rate
Every major filer sorted into ten groups by win rate. Recovery multiple is dollars awarded per $1 the health plan offered.
Top quartile by win rate
Wins 94.3%
Recovers 2.40x
The best win rates in the market.
Bottom quartile by win rate
Wins 74.0%
Recovers 7.13x
Nearly three times the money, on a worse win rate.
CMS Federal IDR Public Use Files, 2025. Analysis of 5,728,139 decided claim lines across 632 high-volume filers. Methodology →
Here's the actual equation.
Once you see it written out, the reason becomes obvious.
The capped half
Win rate can't pass 100%, and the market already sits at 85.6%. That is the entire playing field, and every vendor is selling you a position on it.
The open half
The ask has no cap. Across the same filers it runs from 2.55x to 67.77x. And unlike win rate, the ask predicts money. The correlation is +0.49.
Ask for too little and you win nearly every dispute while collecting nearly nothing.
That is the trade the high win rate filers are making. Most of them don't know it.
Which means the money is decided before you file.
Two choices set it. Which claims you fight, and what you ask for. Both happen before anything is submitted.
Your vendor sets that ask. They set it low.
A conservative offer wins more often, and win rate is what they report back to you. Their number looks good. Yours doesn't move.
One filer in the public data asks 37x and still wins 86% of the time. Most sit between 2.4x and 5.9x. The ceiling is far above where the market is bidding.
Wouldn't asking for more just mean losing more?
No. In the public file, bigger asks track with more money recovered, not fewer wins. The trade-off everyone assumes is there does not show up in the data.
We optimize for what you recover.
Which is why we start with the two choices that set it.
Find what's eligible
We read your 837 and 835 files and map every out-of-network claim to its IDR eligibility and its deadlines.
Rank what's worth fighting
Not every claim is. Filing the wrong ones costs you arbitration fees and wins you nothing.
Ask for what the comparables support
We build the offer from comparable rates and the payer's own history, then file it before the clock runs out.
We take a lower fee.
A bigger recovery pays us both more. We would rather earn less of more.
Take $1,000,000 in health plan offers.
for you, from the same disputes and the same health plan offers.
for us, at a lower fee. Almost all of the gain goes to you.
Worked example. Fee percentages are illustrative.
We already have your filing record.
Every dispute you have ever filed is in the CMS public file, including which email address submitted it.
We will pull yours and show you what it says. Nothing needed from you. No data to send, no agreement to sign.
Let us show you how it could be better.
Built to sit inside what you already run.
- Works from the 837 and 835 files you already produce
- No new system of record
- HIPAA-aligned handling of PHI, Business Associate Agreement available
- Least-privilege access, audit logging, encryption in transit and at rest