First Choice Health (FCH), a leading provider-owned healthcare organization offering innovative and customized benefit solutions to members nationwide, today announced new results from its collaboration with Daffodil Health, showing that, using Daffodil’s technology, more than 99% of its nearly 2,000 No Surprises Act (NSA) claims were resolved without the independent dispute resolution (IDR) process.

That high provider acceptance rate was accompanied by significant financial savings for FCH. Across the 1,927 claims processed, representing more than $4 million in provider-billed charges, Daffodil’s Qualifying Payment Amount (QPA) application reduced the amount payable by 56.8% to $1.75 million. By cutting costs by more than half without driving claims further into the dispute process, the results demonstrate FCH’s ability to better control out-of-network costs while minimizing costly downstream disputes and member friction.

“While others let out-of-network negotiations stall and leave patients caught in the middle, we needed a way to resolve claims fast,” said Anisha Sood, Chief Financial and Strategy Officer at FCH. “Daffodil gives us exact, defensible numbers in real time, allowing us to lock in fair agreements before friction builds or arbitration ever enters the picture.”

The FCH results come at a pivotal time for the NSA’s IDR process, as health plans face new scrutiny over how QPAs are calculated and defended. Most recently, the Fifth Circuit Court struck down the use of “ghost rates” in QPA calculations and ruled that bonus and incentive payments must be factored in, raising new questions about the payer-calculated rates used in payment disputes. For health plans relying on internally mandated fee schedules or a single benchmark, the ruling could require significant changes to how QPAs are calculated and supported.

For payers and third-party administrators like FCH, navigating this complexity starts with having consistent data and infrastructure behind each payment decision. Daffodil’s NSA solution gives FCH that foundation, while also automating dispute intake and triage, benchmarking disputed claims against both CMS and FAIR Health data, and generating AI-supported negotiation strategies and arbitrator recommendations.

“The Fifth Circuit’s ruling fixes a flaw in how QPA gets calculated, but it doesn’t solve the deeper problem,” said Navin Nagiah, CEO and Co-Founder of Daffodil Health. “Providers still win the overwhelming majority of arbitration cases, and most payers still don’t have the infrastructure to defend their numbers once a case gets there. FCH’s results are what happens when a health plan closes that gap itself, instead of waiting on a vendor or court to do it for them.”

FCH’s outcomes follow Daffodil’s July launch of the NSA dispute management solution for payers and TPAs, built to manage disputes across intake, negotiation, arbitration, and reporting workflows. The company also closed a $16.3 million Series A in February 2026, led by Flare Capital Partners, to support its product development, expand deployments, and improve claims transparency.

For more information on Daffodil’s solutions for out-of-network claims processing, please visit https://daffodil.com.

About Daffodil Health:

Daffodil Health is an AI-first healthcare technology company modernizing the claims and pricing infrastructure used by U.S. health plans. Its configurable, transparent platform enables payors and third-party administrators (TPAs) to bring out-of-network (OON) repricing and payment integrity in-house—without added operational complexity or labor costs.

Daffodil replaces opaque, percentage-of-savings middlemen with a modern SaaS model that gives plans direct control over pricing logic, real-time reporting, and defensible benchmarks that withstand regulatory and audit scrutiny. Built to work alongside existing core claims systems, the platform supports next-generation plan designs such as reference-based pricing, narrow and tiered networks, and dynamic copays.

Across its customers, Daffodil has delivered consistent seven-figure improvements in plan margins by reducing administrative waste and aligning incentives. Headquartered in San Francisco, the company’s mission is to help health plans lower costs, improve auditability, and enable more sustainable, member-centric benefit designs.

About First Choice Health:

First Choice Health (FCH) is a provider and hospital-owned, forward-thinking alternative to traditional health insurance. With over 40 years of experience, First Choice Health creates integrated healthcare solutions that reduce costs, promote transparency, and deliver exceptional service across all business lines.

PPO Network | Third-Party and Network Administration | Employee Assistance Program | Medical Management | Provider Data Solutions

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