Navigating IDR Challenges and Change with Max Mangum – Health Innovation Matters
Michael chats with Max Mangum, Co-founder and CEO of Pivotal Health. Together, they discuss the purpose of the Independent Dispute Resolution (IDR) process under the No Surprises Act and why it was created to help ensure fair out-of-network reimbursement; the administrative and reimbursement challenges providers face when trying to participate in IDR; how growing administrative complexity is limiting provider access to the process; the impact of CMS’s updated IDR rules on transparency, efficiency, provider reimbursement and eligibility; the role of AI and human expertise in reducing administrative burden and supporting compliant reimbursement workflows; and what it will take to ensure IDR remains a fair, efficient, and sustainable process for providers, payers, and patients.
Learn more about Pivotal Health at www.PivotalHealth.ai.
About Our Guest
Max Mangum is the Co-founder and CEO of Pivotal Health, a technology-enabled partner that helps physician groups and revenue cycle management organizations navigate the No Surprises Act’s Independent Dispute Resolution (IDR) process.
Prior to founding Pivotal, Max worked in healthcare investing at The Cranemere Group and in the Global Healthcare Group at Barclays, where he advised healthcare organizations on strategic and financial transactions.
He holds a master’s degree from Duke University’s Fuqua School of Business and a bachelor’s degree in economics from the University of Virginia.
Health Innovation Matters 