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Pivotal Health operates a full-service Independent Dispute Resolution (IDR) platform helping providers secure fair payer reimbursement under the No Surprises Act. It combines automated technology tied to major revenue cycle systems, data analytics that build supporting evidence for disputes, and professional services guiding clients through the process end to end. Clients span specialties with heavy out-of-network exposure, including emergency medicine, anesthesiology, radiology, surgery, air ambulance, and hospitals. What sets Pivotal Health apart is its payment model: it collects fees only after clients are paid, aligning its incentives with provider outcomes. The goal is to restore balance to healthcare reimbursement, equipping providers to navigate an unpredictable payer landscape.
Industries
Data & Analytics
Consulting
Enterprise Software
Healthcare
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Headquarters
New York City, New York
Founded
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DALLAS, March 26, 2025 /PRNewswire/ -- Ventra Health ("Ventra"), a leading business solutions provider for facility-based physicians, announced today that it has formed a strategic partnership with Radix Health ("Radix"), the innovative No Surprises Act Independent Dispute Resolution (IDR) solutions provider, to help its physician clients optimize out-of-network reimbursement and strengthen their overall payer strategy. Ventra is one of the nation's largest, most sophisticated technology-enabled providers of comprehensive end-to-end revenue cycle management (RCM) services, offering clients access to industry-leading technology, data and analytics, provider education, and payer strategy and contracting
Comprehensive and holistic approach helps providers achieve fair payments and reduce the risk of insurer underpaymentAUSTIN, Texas and LOS ANGELES, Jan. 28, 2025 /PRNewswire/ -- PayrHealth, the industry's leading Complete Payor Management solution, and Radix, the only software-based No Surprises Act Independent Dispute Resolution ("IDR") solution, today announced a strategic partnership to deliver a holistic contracting and reimbursement strategy for healthcare providers, enabling them to maximize revenue while minimizing administrative burden and risk. Passed in 2020, the No Surprises Act has redefined out-of-network reimbursement. The law was created to protect patients from surprise medical bills for out-of-network care. However, payors can now push providers out-of-network and slash allowable amounts for care, effectively lowering reimbursement rates. Radix offers end-to-end claims arbitration through its IDR software on behalf of providers for fair reimbursement at scale
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Industries
Data & Analytics
Consulting
Enterprise Software
Healthcare
Company Size
N/A
Company Stage
N/A
Total Funding
N/A
Headquarters
New York City, New York
Founded
N/A
Find jobs on Simplify and start your career today