HaloMD

HaloMD is a healthcare reimbursement company that focuses exclusively on Independent Dispute Resolution (IDR) under the No Surprises Act and state balance billing prohibitions. The federal No Surprises Act limits what patients can be billed for many out-of-network services and creates an arbitration process where providers and health plans each submit a payment offer to a certified independent entity, which selects one. The company says it pairs regulatory and out-of-network expertise with data-driven technology to pursue predictable reimbursement for providers in these disputes, and it reports an average win rate of 90% and more than $1B secured in award determinations.

The federal IDR process runs on tight timelines and requires documentation for every case, so handling a large caseload is a heavy administrative burden for provider groups. HaloMD manages this work at scale with a proprietary platform: providers submit disputes via a portal, the system checks each case for eligibility under federal and state rules, and analytics are used to evaluate insurer offers. Its team then prepares the documentation, and the platform submits each dispute to the IDR entity within federal or state deadlines. Negotiation involves the company's legal and financial specialists, and providers receive ongoing reporting on outcomes and trends.

HaloMD says it supports thousands of healthcare providers across the country and has handled hundreds of thousands of IDR filings. Its commercial focus covers emergency medicine, anesthesia, radiology and other out-of-network specialties, fields in which patients usually do not choose their clinician and payment disputes with health plans are common. The company frames its mission as securing fair reimbursement so providers can keep delivering care, names integrity, innovation, excellence and collaboration as its values, and presents its work as helping providers deal with payors on more equal terms.