Out-of-network RCM

Out-of-network claims, paid what they're worth.

Evident is a full-service RCM company specializing in out-of-network claims. We negotiate every underpaid claim, and take it to IDR when payers won't move.

Get a free claims assessment

Send us 3-5 out-of-network EOBs. In three business days, we'll show you what's recoverable. No upfront cost.

Prefer to ask a question first? Email hello@evidentrcm.com →
Since 2022
Working IDR under the No Surprises Act
20+ yrs
Revenue cycle management experience
Claims assessment · Confidential
Prepared forOrthopaedic group, TX
Claims reviewed3 out-of-network
Potentially recoverable
$5,960
Paid $2,210 of an estimated $8,170 fair value — 3.7× what the payer paid.
CPTPaidFair valueNext step
27447Total knee arthroplasty$1,120$4,650Negotiate
01402Anesthesia, knee arthroplasty$680$2,140Negotiate
95940Intraoperative neuromonitoring$410$1,380IDR
Illustrative example. Fair value benchmarked against payer data and federal IDR outcomes.
The problem

Providers win most disputes. Most independent practices never file.

~85%
of federal IDR payment determinations went to providers in 2024
447%
median winning provider offer, as a share of the payer’s QPA (Q2 2024)
63%
of resolved IDR cases came from just five large, mostly PE-backed groups

Sources: Congressional Research Service analysis of federal IDR data, 2024; Health Affairs Forefront analysis of federal IDR public use files, Q1–Q2 2024.

What we do

Full-service billing. Out-of-network expertise.

Out-of-network negotiation

Out-of-network payments vary widely. We challenge low payments with payer data and negotiate a fair rate on every claim.

Independent Dispute Resolution

When negotiation stalls, we take the claim to federal arbitration under the No Surprises Act — every filing and deadline handled.

Full-cycle RCM

In-network, Medicare, and commercial billing — coding, claims, denials, posting, and A/R — run by the same team.

See all services
How it works

Three steps to getting paid.

01

Send us 3-5 EOBs

Your higher-dollar out-of-network claims. We send a secure upload link and sign a BAA on request.

02

Get a free assessment

In three business days: claim by claim, what was paid, what it should have paid, and what’s recoverable.

03

We recover it

We negotiate first and go to IDR when needed. Your patients are never balance-billed.

Who we serve

Built for specialties that bill out-of-network.

OrthopaedicsAnesthesiaNeuromonitoringAssistant surgeonsEmergency medicineRadiologyLabs & ancillaryAmbulatory surgery centers

We also partner with billing companies that want out-of-network negotiation and IDR handled for their clients.

Anupam Pradhan, MD

Evident was founded by Anupam Pradhan, MD, a practicing orthopaedic surgeon who has seen underpaid out-of-network claims firsthand.

About Evident

See what your claims were actually worth.

Send us 3-5 out-of-network EOBs. We'll show you, claim by claim, what's recoverable — free, in three business days.

Get a free claims assessment