Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities and Providers of Air Ambulance Services
No Surprises Act: IDR Process
OMB: 1210-0169
IC ID: 248846
Documents and Forms
Document Name Document Type |
|---|
Other-Notice of Open Negotiation |
Other-Notice of IDR Initiation |
Other-Notice of Certified IDR Entity Selection |
Other- Notice of Agreement on an Out-of-Network Rate |
Other-Notice of Offer Data Elements |
Other-IDR Initiation Webform |
Other-IDR Entity Selection Response Webform |
Other-Notice of IDR Initiation Response |
Other-Notice of Open Negotiation Response |
Other-Withdrawal Notice |
Information Collection (IC) Details
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