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New Analysis: No Surprises Act Cuts Out-Of-Network Emergency Spending by as Much as 52%

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Most Conservative Model Estimates Nearly $1 Billion in Annual Savings as Only 9% of Eligible Emergency Medicine Claims Reach Arbitration

DALLAS, Sept. 3, 2026 /PRNewswire/ — HaloMD today released a new analysis finding that out-of-network (OON) emergency medical spending has declined between 13% to 52% since the No Surprises Act (NSA) took effect in January 2022. Even under the analysis’s most conservative assumptions, OON spending was almost $1 billion lower than it would have been pre-NSA.

The research draws on publicly available data from the Brookings Institution’s NSA Arbitration Databook, newly released CMS IDR Public Use Files, surveys conducted by AHIP and Blue Cross Blue Shield Association, and FAIR Health analyses. The analysis established a pre-NSA OON baseline for emergency medicine of approximately $641.71 per claim and compares that baseline against modeled post-NSA spending across claims resolved through initial payment, open negotiation and formal independent dispute resolution (IDR).

“The NSA has successfully protected patients, but this analysis shows it has also served a secondary goal of lowering medical costs,” said Patrick Velliky, Chief External Affairs Officer at HaloMD. “We focused on out-of-network emergency medicine because it represents the most substantial portion of claims within the NSA framework. What we found, even under the most conservative approach to the data, is an estimated $1 billion in annual savings compared to pre-NSA amounts.”

Key Findings

Applied to the approximately 11.9 million OON emergency medicine claims subject to NSA, the model finds estimated annual savings of $978 million to $3.95 billion compared to the pre-NSA baseline. Other key findings include:

The analysis estimated that OON emergency spending declined 13% to 52%, depending on payment rates for claims resolved without formal arbitration.Most claims never reach formal arbitration. Per AHIP and BCBSA survey data covering 2024, 76% of NSA-eligible claims were resolved by the insurer’s initial payment. HaloMD estimates that approximately 9.5% of OON emergency medicine claims subject to the NSA proceeded to formal IDR in 2025.The mean 2025 IDR award for emergency medicine was approximately $630 per claim, which closely tracks with the analysis’s estimated pre-NSA OON baseline of approximately $642.

Why the Findings Matter

The NSA was designed to protect patients from unexpected out-of-network bills and created a new process to resolve disputes between insurers and clinicians. HaloMD’s analysis examines a separate question, important for all stakeholders: has the law increased or decreased medical spending?

“The data tell a clear story: when the entire out-of-network payment system is considered, arbitration is a small fraction of the whole,” said Alla LaRoque, President and CEO of HaloMD. “Patients are spending less on emergency medical care today because of the No Surprises Act.”

The findings carry significant implications for ongoing policy discussions surrounding the NSA. Much of the literature has focused solely on IDR awards, without accounting for the much larger volume of claims resolved through an initial payment or open negotiation. As Congress looks to refine implementation, HaloMD’s analysis offers a data-driven foundation for evaluating the law’s real-world impact on the broader healthcare system.

Methodology

The analysis established a pre-NSA OON baseline using historical out-of-network allowed amounts for emergency medicine compiled by the Brookings Institution. It then models post-NSA spending across two payment pathways: eligible claims resolved following an insurer’s initial payment or open negotiation, and claims decided through formal IDR. Because public payment data are not available for claims subject to the NSA and eligible for the IDR process, but resolved outside of IDR, the analysis evaluates three scenarios in which those claims are paid at the qualifying payment amount, 150% of the qualifying payment amount and 200% of the qualifying payment amount. The resulting estimates are compared with the pre-NSA baseline to calculate a range of estimated annual savings.

About HaloMD
HaloMD is the #1 provider of Independent Dispute Resolution (IDR) services as indicated by public CMS data, backed by industry leading technology infrastructure and data intelligence. The company supports healthcare providers navigating the federal No Surprises Act and state balance-billing laws, combining proprietary technology, advanced analytics, and deep specialty expertise to advance fair reimbursement, long- term financial sustainability, and empowering care teams to focus on providing high quality patient care.

Privately held and founder-led, HaloMD serves more than 25,000 providers, from independent physicians to hospitals and health systems, across 50 states and Washington, D.C., so they can continue caring for the patients and communities they serve.

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SOURCE HaloMD

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Ally Waste Acquires Swift Integrated Services, Expanding Service Capabilities and Market Reach

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GILBERT, Ariz., Sept. 3, 2026 /PRNewswire/ — Ally Waste, a nationwide provider of comprehensive waste solutions for multifamily communities, announced today that it has acquired Swift Integrated Services, a Utah-based provider of dumpster management, doorstep trash pickup, and waste brokerage services.

“Every acquisition we make starts with the same question: Will it help us serve customers better? Swift expands our reach and brings capabilities that allow us to support more of our customers’ waste needs. We’re excited to welcome the Swift team to Ally and build on what they’ve created,” said James Crawley, CEO of Ally Waste.

The acquisition expands Ally Waste’s presence in Utah, Florida, and Idaho markets while strengthening the company’s waste stream optimization capabilities. It also brings waste brokerage capabilities to Ally, giving current customers another way to address their waste needs as the offering is integrated.

“Joining Ally gives us the opportunity to build on what we’ve created while bringing our customers the support and resources of a nationwide team,” said Indigo Schumann-Curtis, President of Swift Integrated Services. “Our customers can expect business as usual, with many of the same people continuing to support them. I’m excited about what our teams can accomplish together.”

Swift Integrated Services customers can expect continuity in both service and support throughout the transition. The Swift team will continue with Ally, bringing established customer relationships and deep market knowledge to the combined organization.

About Ally Waste

Ally Waste is a nationwide provider of comprehensive waste solutions for multifamily communities, including valet trash and recycling, bulk removal, and waste stream optimization services. Its technology gives owners and operators clear visibility into what they’re paying for waste across a portfolio, paired with on-the-ground teams who put those insights into action.

The company’s culture is grounded in its values of Integrity, Grit, and Humility. These principles drive Ally Waste’s commitment to supporting multifamily teams and delivering consistent, high-quality service that improves everyday life for residents and on-site staff. Learn more at www.allywaste.com.

Media Contact:
Doridé Uvaldo
duvaldo@allywaste.com

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SOURCE Ally Waste

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Gupshup Launches Self-Serve Voice AI Platform, Extending Conversational Engagement into Phone Calls

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Businesses can now build, test, and deploy AI voice agents across support, sales, and operations – alongside WhatsApp, RCS, and SMS – from a single platform

MUMBAI, India and SAN FRANCISCO, Sept. 3, 2026 /PRNewswire/ — Gupshup launched its Voice AI Platform, a self-serve console for building and running AI voice agents that handle calls end to end. The launch extends Gupshup’s engagement platform from messaging into voice, bringing support, sales, and operations onto the same infrastructure businesses use for WhatsApp, RCS, and SMS.

Gupshup’s Voice AI Platform resolves support calls, qualifies and converts leads, and automates operational calls such as scheduling, verification, and payment reminders, so human teams can focus on conversations that require a person.

The platform covers agent lifecycle in a no-code, prompt-based interface. Businesses configure an agent’s voice, language, knowledge base, system prompt, and workflows, then connect it to tools their teams use. Before going live, teams define guardrails, run simulations, and validate behaviour with tests – comparing models. Once deployed, analytics track success rates, satisfaction, and language usage, with transcripts, conversation history, and debug logs for review.

Gupshup’s platform is the first to bring unique capabilities. First, voice is a channel extension of a platform serving businesses across WhatsApp, RCS, and SMS – enabling voice-and-messaging experiences within a customer journey. Second, it supports telephony: PSTN and WhatsApp voice channels, on-premise and cloud deployment, and the option to bring PSTN infrastructure. Third, it is model-flexible – businesses choose speech-to-text, text-to-speech, and LLM providers rather than accepting a stack.

The platform builds on Gupshup’s experience powering customer engagement for 50,000+ businesses across 100+ countries and 25+ industries, processing 10 billion interactions monthly, including 500 million voice calls per month.

The Voice AI Platform has been beta tested and delivered outcomes across deployments. Users receive 100 minutes of credits to test, and pricing starts at USD 0.035 (INR 3.50) per minute.

“For customer engagement in emerging markets, Voice AI drives universal access – reaching every user regardless of language or literacy. In developed markets, it drives efficiency and automation. In both, it delivers cost savings, revenue growth, and satisfaction. With the launch of its Voice AI Platform alongside its messaging, Gupshup offers the only unified self-serve platform for customer engagement across voice and messaging,” said Beerud Sheth, Co-founder and CEO, Gupshup.

The Voice AI Platform is available to businesses at voiceai.gupshup.io.

For more information, visit www.gupshup.ai.

 

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SOURCE Gupshup Technology India Pvt Ltd

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Deepdub Launches Phantom Z 3.4 Conversational: Multilingual Text-to-Speech Built to Survive Real Customers, Not Just Demos

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Enterprise-grade real-time text-to-speech delivers 150ms time to first audio at full 48 kHz, with text normalization that gets account numbers, invoice totals and appointment dates right

TEL AVIV, Israel, Sept. 3, 2026 /PRNewswire/ — Deepdub, a foundational voice AI company pioneering expressive voice technologies, announced today the launch of Phantom Z 3.4 Conversational, a new multilingual text-to-speech model with high-fidelity 48 kHz audio, improved text normalization and extended Hebrew support. The model is available to all Deepdub clients now.

For enterprises running voice agents, a call holds together when four things go right at once. The voice sounds like a person. The response arrives fast enough to feel like a conversation. The agent knows when to speak and when to listen. And every account number, date and amount comes out the way a customer would say it. When one of them slips, the call escalates to a human, and that is where containment and cost are decided. Phantom Z 3.4 Conversational is built for all four.

“Every voice model sounds impressive for two minutes in a demo. Very few survive two weeks with real customers,” said Ofir Krakowski, CEO and co-founder of Deepdub. “Deployments don’t stall on the 95% a model gets right, they stall on the misread account number, the mangled surname, the one wrong digit on a live call. We built this model for that last few percent, because in production, the last few percent is the whole product.”

In English, the work is in text normalization, the step that turns written text into spoken words. A delivery date written 2024-12-31 is read as December thirty first, twenty twenty-four rather than as a run of digits. An invoice total written $1,240 is read as one thousand two hundred forty dollars. An appointment at 14:30 is read as two thirty. A reference written Chapter VII is read as chapter seven rather than as letters. These are the categories where Deepdub’s testing puts the model ahead of the other systems it was measured against. An enterprise running more than one language gets one set of behavior to test and one contract to hold rather than two.

Phantom Z 3.4 delivers an end-to-end p95 time-to-first-audio of 150 milliseconds in real-time mode at full-range 48 kHz audio, with cross-language voice transfer from under three seconds of reference audio. Deepdub builds and trains its own speech models from random rather than licensing them, which allows the company to bring a new language into production in two weeks. Deepdub covers more than fifty locales and dialects verified by local voice and language experts, inside a platform supporting more than 50 locales and dialects.

“We run Deepdub in production for live, real-time phone calls, where latency and naturalness aren’t nice-to-haves but the key factor in whether a caller stays on the line. 3.4 is the closest we’ve heard a synthetic voice come to a real person, and our callers show it: they stay longer, talk more, and engage with our agents like we’ve never seen before,” said Adir Haziza, CTO at Voiceman.

The hardest case is Hebrew, which is written without vowels, so the same letters can spell different words. The three letters of שלט are a sign read one way and a remote control read another. A model that reads one word at a time has to guess which the sentence means, and in Hebrew a wrong guess is not an accent, it is a different word that stays invisible until a customer hears it. Phantom Z 3.4 resolves this at the source. Pronunciation is decided from the whole sentence rather than word by word, and every instance of שלט in Deepdub’s Hebrew test set was read correctly. Where a brand name or a plan tier has to be said a particular way, marking it in the text is enough. Deepdub ranks first for Hebrew text-to-speech on the public TTS Arena leaderboard hosted by ivrit.ai on Hugging Face.

In Hebrew, national ID numbers, appointment dates and transaction amounts are expanded before speech, so a balance written as 1,240 ₪ is spoken in full rather than read out as digits. In blind listening tests, Phantom Z 3.4 was preferred over Deepdub’s previous Hebrew model in 71 percent of decisive comparisons.

“We needed something that would hold up consistently across a large volume of work, so we tested it thoroughly before deciding. What stood out was that the details came out right and the Hebrew was the most natural we’d heard,” said Dor Levy, Head of Jeen Talk at Jeen AI.

About Deepdub
Deepdub is the foundational voice AI model company pioneering expressive voice technologies for global enterprises across TV, film, advertising, gaming, e-learning, and AI-agent applications. The company’s international team of technology, dubbing, and linguistic experts deliver an end-to-end voice solution that preserves the emotional and cultural integrity of original content in more than 50 locales and dialects. With an advisory board that includes media leaders such as Kevin Reilly, former Chief Content Officer at HBO Max, and Emiliano Calemzuk, former President of Fox Television Studios, Deepdub is eliminating language barriers to enable the global diffusion of media on major streaming platforms like Netflix, Amazon Prime, and Hulu. Visit https://deepdub.ai or follow us on LinkedIn for more information.

Deepdub Media Contact
Zivit Katz
Deepdub
zivit.katz@deepdub.ai

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SOURCE Deepdub

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