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Protecting Plans & Patients Across the U.S.

Medical Billing Disputes Create Noise. We Handle It So You and Your People Don't Have To.

When a provider challenges a self-funded health plan's payment, or a plan participant receives a balance bill they don't know how to handle, most employers have nowhere to turn. aequum provides medical billing advocacy and legal defense for self-funded health plans and their plan participants, managing out-of-network billing disputes, defending against balance billing, and handling No Surprises Act IDR cases so the noise stops and the plan stays protected.
900+ Self-funded plans served
97.2% Savings off disputed charges
15,000+ Claims handled
297 Avg. days from referral to resolution
* Results vary. The outcome of each matter depends on the specific facts involved. Past results do not guarantee a similar outcome in any future case.
What We Do

Legal Strategies for Healthcare Cost Containment

Healthcare costs can be influenced by many factors, including provider pricing, billing complexity, and administrative challenges. aequum helps self-funded health plans identify opportunities to reduce unnecessary costs, support plan participants through billing-related issues, and facilitate resolution of payment disputes before they become larger challenges. The solutions below highlight two of the primary ways we help plans manage costs and improve member experience.

01

Medical Billing Defense

We defend plans and members against inflated out-of-network bills, collections pressure, balance billing, and the noise that follows when disputes go unmanaged. When a provider issues an inflated out-of-network bill or attempts to balance bill a member, most self-funded employers don't have the internal resources to respond effectively. aequum reviews the bill, contacts the provider, challenges improper charges, and manages the dispute end to end. The plan is defended. The member isn't left alone.
Plan Participant & Patient Advocacy Out-of-Network Negotiation Overpayment Recovery
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02

No Surprises Act Defense

We manage the NSA IDR process for payers so you don't have to bear the administrative burden and defend against unfair or improper awards. The No Surprises Act protects patients from surprise bills. For health plans, it also created the Independent Dispute Resolution (IDR) process, a federal arbitration system that providers are using aggressively to demand payments well above what the plan originally paid. Without active defense, self-funded plans routinely overpay. aequum reviews whether disputes even qualify, manages open negotiations, and defends IDR cases with a consistent legal strategy.
NSA Eligibility Review IDR Process Management Post-Award Advocacy
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What Makes Us Different

Why aequum Is Different

Self-funded health plans face a complex healthcare ecosystem with multiple stakeholders, evolving regulations, and rising costs. Successfully managing plan spend requires more than simply processing claims. It requires visibility, advocacy, and proactive cost-containment strategies. aequum works alongside employers, brokers, administrators, and other partners to help plans identify unnecessary costs, support plan participants through billing challenges, and provide documentation that supports fiduciary oversight and informed decision-making. Our collaborative approach helps plans control costs while improving the member experience.

Attorney-Backed Advocacy

aequum's work is grounded in legal practice. Through its partnership with a national law firm, every dispute is handled with attorney-level precision, not just administrative follow-up.

We Step In Early

Disputes can take many forms, from out-of-network billing challenges to collection notices and member concerns. aequum helps self-funded health plans and plan participants navigate these issues strategically, providing legal advocacy and billing support at every stage of the process.

Audit-Ready Reporting

Every dispute is tracked and documented. Plan sponsors get full visibility into how disputes are being handled, which is the paper trail ERISA fiduciary responsibility requires.

What Our Partners Say

Trusted Across the Self-Funded Market.

"

Their success rate with balance billing issues presented to them has been in excess of 99% by any standard of measurement. They have been shown to be the most effective solution to the only real impediment to adopting reference based pricing.

Jim Farley J.P. Farley Corporation * Results vary. Past results do not guarantee a similar outcome in any future matter.
"

We've been working with aequum for over 3 years and couldn't be happier. Their knowledge and advice has been invaluable to us as a Third Party Administrator.

Pat Sanders Insurance Management Services, Inc. * Results vary. Past results do not guarantee a similar outcome in any future matter.
"

Aequum's expertise in balance billing disputes and IDR proceedings strengthens the foundation of the pricing solutions we deliver at ClaimsBridge. Their ability to navigate complex regulatory frameworks while driving practical outcomes makes them a trusted and highly valued partner in the self-insured market.

Kevin Gibson CEO, ClaimsBridge * Results vary. Past results do not guarantee a similar outcome in any future matter.
Who We Serve

Who We Work With

aequum works with self-funded employers, third-party administrators (TPAs), brokers, stop-loss carriers, reference-based pricing plans, and cost-containment partners across the United States. If your plan is dealing with out-of-network billing disputes, No Surprises Act IDR exposure, or health plan compliance questions, we're built for that.

Self-Funded Employers

"We keep getting hit with out-of-network bills our plan didn't expect to pay."

How we help +
Self-Funded Employers

Mid-sized to larger employers running a self-funded health plan who need active out-of-network billing defense and want to stop overpaying on disputed claims.

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Third-Party Administrators (TPAs)

"Our clients are getting NSA IDR filings and we don't have a legal defense in place."

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Third-Party Administrators (TPAs)

Third-party administrators managing self-funded plans who need support with balance billing disputes, NSA compliance and IDR matters, particularly those with reference-based pricing (RBP) arrangements or high out-of-network claim volume.

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Reference-Based Pricing Plans

"Providers keep balance billing our members and we're spending too much time managing it."

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Reference-Based Pricing Plans

Reference-based pricing plans pay claims based on a reference price, typically a percentage above the Medicare rate, which saves money but regularly triggers provider balance billing attempts. We defend RBP payment determinations and manage those disputes so the plan operates without constant friction.

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Brokers

"My clients need more than I can offer when billing disputes turn into collections pressure."

How we help +
Brokers

Brokers looking to deliver additional value to self-funded clients through healthcare cost-containment solutions, participant advocacy services, and support for complex billing and payment challenges. aequum helps brokers strengthen client relationships while addressing issues that can significantly impact plan costs and member satisfaction.

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Cost Containment Partners

"We can reprice the claim. But when a provider pushes back legally, we need backup."

How we help +
Cost Containment Partners

Cost-containment organizations that provide innovative health plan solutions including repricing, care navigation, payment integrity, and other cost-management services often benefit from additional support when complex billing disputes arise. aequum complements these offerings with specialized advocacy services and access to legal resources through its law firm partnership.

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Common Questions

Frequently Asked Questions

aequum provides medical billing defense and No Surprises Act (NSA) defense services. We help self-funded health plans, third-party administrators (TPAs), and their members manage out-of-network billing disputes, challenge inflated and balance-billed charges, and navigate the Independent Dispute Resolution (IDR) process the NSA created. We're the advocate in the room when providers push back on the plan and the member.
Most employers don't realize they have exposure until a dispute lands in HR's inbox or a member calls confused about a bill they can't afford. If your plan covers out-of-network services, or if you use reference-based pricing, billing disputes are part of the territory. The question isn't whether they'll happen. It's whether you have someone to handle them when they do.
A self-funded plan is one where the employer pays employee medical claims directly, rather than paying premiums to an insurance carrier. It gives employers more control over their benefit design and costs, but it also means the employer carries the financial risk. That's why having active defense on disputed claims and billing matters.
Reference-based pricing is a cost-containment strategy where a plan pays providers a defined amount, typically a percentage above what Medicare pays, rather than negotiating network rates. It can save plans significant money, but it often leads to providers pushing back and attempting to balance bill members for the difference. That's one of the most common situations where aequum gets called in.
Medical Billing Defense covers disputes after a bill is issued: balance billing, collections pressure, out-of-network overcharges, and overpayment recovery. NSA Defense is specific to the legal arbitration process created by the No Surprises Act, including IDR eligibility review, open negotiation management, notice of offer submission, and post-award work. Many clients use both.
No. By the time we're involved, that step has typically already happened. We focus on what comes after: when a bill is disputed, a provider pushes back, or an IDR case needs to be defended.
The No Surprises Act prohibits providers from balance billing patients for certain out-of-network services. But for health plans, the law also created an IDR arbitration process that providers use aggressively to recover payments above median in-network rates and qualifying payment amounts. Health plan compliance with NSA rules means understanding both sides: the patient protections and the plan's exposure through IDR.

Not Sure Where to Start?

Whether you're dealing with an active dispute or just trying to understand your plan's exposure, our team can walk you through it. No pressure. Just a straight conversation. Talk to Our Team