Claritev Handles Half of Federal No Surprises Act Disputes Amid Record Volume
Event summary
- Claritev managed nearly 50% of federal Independent Dispute Resolution (IDR) claims in 2025, per CMS data.
- Federal IDR disputes surged to 2.5 million in 2025, up from 1.5 million in 2024.
- Total IDR awards exceeded $15 billion in 2025, more than triple the 2024 amount.
- Claritev resolved 270,000 federal IDR arbitrations and negotiated 400,000 post-payment disputes.
The big picture
Claritev's dominance in handling No Surprises Act disputes reflects the law's unintended complexity, with filings exceeding projections by over 100x. The company's scale and technology position it as a critical player in managing this growing administrative burden, but regulatory adjustments could reshape its competitive advantage.
What we're watching
- Regulatory Scrutiny
- Whether CMS will tighten eligibility controls amid rising disputes with potential issues.
- Operational Scale
- The pace at which Claritev can sustain its market-leading position as dispute volumes grow.
- Technology Investment
- How AI-native capabilities will impact early claim resolution and administrative efficiency.