NSA Tracker · Out-of-network arbitration, on the record

Every out-of-network dispute in America. Quarter by quarter. One map.

The No Surprises Act sends provider–insurer payment fights to arbitration, and the result becomes public record. Nobody reads it. Press play and watch the country answer four questions on one timeline — who represents providers, where each insurer sets its benchmark, how big the dollars are, and where the fights are.

Disputed line itemsService lines sent to arbitration — counted from the record.
Estimated dollars in disputeest.A modelled estimate of what those lines are worth, at each cell’s median benchmark.
Exact IDR fees paidThe arbitrators’ own fees — a reported dollar column, counted, never modelled.

Which firm owns each state?

The single provider representative filing the most line items in each state. Watch it change hands, quarter by quarter — this is the market consolidating in public.

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Three ways in

The record answers to whoever’s asking.

The same public arbitration record reads differently depending on who you are. Start where you stand — each link opens the workspace already pointed at your question.

01 · The hallmark

Watch a market change hands.

Early in the record the firm leading the most states was SpecialtyCare, with eight. A year on it was TeamHealth, leading fifteen states at once. By the latest quarter it was HaloMD — which by then also filed more disputed line items than anyone else in the country. None of that is announced anywhere. It is simply what the record says, once you play it in order.

Ten lenses ask ten different questions of the same map — dispute volume, provider win rate, who files on the provider's behalf, which arbitrator hears the case, and where a given insurer sets its QPA.

  • Where are the fights?Dispute volume
  • Where do providers win?Provider win rate
  • Where is arbitration slow?Days to determinationmean
  • Who files on the provider's behalf?Representation type
  • Which firm owns each state?Dominant representative
  • Which insurer is most disputed?Dominant payer
  • Who starts the fight?Who initiates
  • Who arbitrates each state?Dominant IDR entityinferred
  • How much of the map do we actually know?Attribution coverageinferred
  • Where does this insurer set the benchmark?Payer QPA index
02 · The discipline

Exact, estimated, or absent — never blurred.

Exact

Counted, not modelled

Dispute counts, provider win rates, market share, and each payer's benchmark position are counted directly from the public record. No model, no estimate.

Estimated

And it says so

A few figures — like a market's total disputed volume — are modelled estimates, not counts. Wherever one appears it is labeled estimated, with its caveat stated in plain sight.

Absent

Is not zero

A state the record never covered is drawn stippled, not colored pale. A quarter that does not exist is a hole in the timeline, and playback steps over it rather than through it.

03 · The line we do not cross

What this will never tell you.

The dollars a named provider or law firm collected are not recoverable from the public record — not by us, not by anyone. Any product that reports a specific doctor’s arbitration revenue is guessing.

The same discipline forbids a tempting number. Every insurer sets a wildly different benchmark, and we can prove the gap exactly — as an index against each local market. We won’t turn that index into a dollar headline like “UnitedHealthcare’s benchmark is $X,” because that would take assumptions the public record can’t support.

So we publish the index, exactly, and don’t manufacture the dollars.

Open the record.

An independent, public read of the No Surprises Act arbitration record.