Process federal and state Independent Dispute Resolution cases end-to-end. Import cases from CMS, screen eligibility, manage baseball-style arbitration with sealed final offers, analyze all seven statutory factors, and generate AI-powered opinions — all in one platform. Built-in CPT code registry with 16,978+ codes. Included in Professional and Enterprise plans.
From CMS import to completed determination in seven clear steps
Upload CSV/Excel from CMS
6-item eligibility checklist
All checks passed
Arbitrator assigned
Offers being submitted
Winning offer selected
Case finalized
Everything IDR entities need — without the Salesforce consulting bill
Import cases from CMS portal exports (CSV/Excel) with automatic field mapping, CPT code format validation against the built-in 16,978+ code registry, and duplicate CMS reference detection. Download the CSV template before your first import. Supports up to 50,000 rows per upload.
Final-offer arbitration enforced at the platform level. Sealed offers, locked submissions, optional per-dispute deadlines with automatic reminders, and the arbitrator selects one offer exactly as written.
Six-item manual checklist covering jurisdiction, batching, timelines, negotiations, disclosures, and QPA. Auto-advances status when all checks pass.
Structured analysis for all 7 required factors with free-text findings and supported/not-supported toggles. Completeness validation ensures all jurisdiction-required factors have findings before determination. Federal vs Texas branching built in.
Track QPA and Fair Health 50th/80th percentile benchmark data per dispute. Federal cases show QPA fields; Texas cases show Fair Health fields.
Generate complete draft opinions following standard IDR template structure. Regenerate with custom instructions. Multiple versions tracked. 4,000-8,000 tokens per generation.
Quarterly CSV exports aligned to the CMS Public Use File format with automatic reminders to administrators at the start of each reporting period. Always exported in English per CMS requirements.
Per-arbitrator reporting: total cases, average days to determination, provider win rate, and plan win rate. Full audit trail for URAC accreditation support.
Export opinions as professionally formatted Word documents with entity branding, 10 structured sections with Roman numeral headings, financial tables, signature block, and page numbers — ready for review and signing.
Search-as-you-type across 16,978+ CPT and HCPCS codes from the CMS Medicare Physician Fee Schedule. Results include code number and category for all users. AMA-licensed tenants see procedure descriptions and can search by description text.
The No Surprises Act requires baseball-style arbitration where each party submits a single final offer. Vilulia enforces this at the platform level — no workarounds, no exceptions. Set optional per-dispute deadlines with automatic 24-hour reminders and past-due alerts.
Structured analysis with jurisdiction-aware display for Federal and Texas cases
I. Authority & Jurisdiction
This determination is issued pursuant to 45 CFR Part 149, Subpart B...
II. Services at Issue
CPT 27447 — Total knee arthroplasty, DOS 2024-03-15...
V. Statutory Factor Analysis
Factor 1 (Medical Necessity): Supported. The provider demonstrated...
Vilulia's AI generates a complete draft opinion following the standard IDR template — reducing a 2-4 hour manual process to under 30 minutes of arbitrator review.
Salesforce requires $150K-$300K in custom consulting to build IDR workflows from scratch, plus $300-$450/user/month in licensing. Vilulia includes purpose-built IDR tools in every Professional and Enterprise Arbitrate subscription.
Medical Billing IDR is included in Professional and Enterprise tiers of Vilulia Arbitrate and Vilulia Complete at no additional monthly cost.
Enterprise pricing is custom-negotiated and can be discounted or waived as part of enterprise contracts.
Join IDR entities already using Vilulia to process No Surprises Act disputes faster and more consistently.
Professional and Enterprise plans include Medical Billing IDR at no additional monthly cost.