NO SURPRISES ACT
NSA/IDR Insurance Negotiation
We manage the required Open Negotiation process under the No Surprises Act. We prepare your Open Negotiation Notice and handle payer communications so deadlines and requirements aren't missed.
What We Handle
- Prepare and send the official Open Negotiation Notice.
- Manage payer responses, counteroffers, and follow-ups.
- Track required timelines and documentation throughout the negotiation period.
Who This Is For
- Hospitals and hospital facilities.
- Emergency rooms and hospital-based departments.
- Healthcare providers, including non-physician practitioners.
- Urgent care centers and outpatient facilities.
- Air ambulance companies.
- Billing teams handling NSA negotiation workflows across multiple providers.
- Groups needing a structured process without tracking deadlines manually.
What We Need to Get Started
- Complete the intake form.
- Provide payment or denial details.
- Upload all pertinent documentation regarding your denial(s).
(We may request additional documentation later if needed.)
Why NSA/IDR Negotiation Matters
Under the No Surprises Act, a formal Open Negotiation is required before a payment dispute can move forward.
- Negotiation is not optional.
- Negotiation has strict timelines.
- Negotiation requires a compliant Open Negotiation Notice.
- Negotiation creates the official negotiation record for the claim.
- Open Negotiation phase is mandatory prior to initiating IDR processing.
Even when negotiation does not result in a settlement agreement, completing this step correctly is critical to preserving next-step options for IDR arbitration.
Common Scenarios We See
If any of these sound familiar, NSA/IDR negotiation may apply.
- Out-of-network emergency services paid far below expectations
- Out-of-network services at in-network facilities subject to No Surprises Act rules
- Out-of-network claims where payers delay or ignore negotiation outreach
- Out-of-network claims nearing IDR timelines that need a compliant negotiation record
What Happens Next
A clear, compliant path through Open Negotiation
We review eligibility, secure authorization, and manage the Open Negotiation process so you don't have to interpret regulations or monitor statutory deadlines.
- Step 1Eligibility & intake review
Confirm No Surprises Act applicability, timing requirements, and complete case information so we can proceed promptly.
- Step 2Invoice + authorization
We obtain all necessary authorizations before commencing negotiations.
- Step 3Open Negotiation with the payer
We prepare the Open Negotiation Notice, manage out of network payer communications, and document the negotiation process in line with federal requirements while not acting as the arbitrator, and keep your file ready if IDR arbitration is needed.
What This Service Is (and Isn't)
This service supports the Open Negotiation period required under the No Surprises Act. We act as your authorized representative to prepare required notices and manage payer communications during this phase.
Under the No Surprises Act, the role of the arbitrator (certified IDR entity) is strictly defined to ensure neutrality; they are not permitted to participate in the negotiation process. We are not the arbitrator; if negotiation is unsuccessful, your required documentation will be ready for the IDR arbitration stage. Our role is to manage the negotiation process in a structured, compliant way so requirements and timelines are met.
FAQ
NSA/IDR Negotiation FAQs
How quickly do you send the Open Negotiation Notice?
Once we receive complete information and authorization, we aim to send the Open Negotiation Notice promptly so the negotiation period begins within required timelines.
Can you help with multiple denials for one provider?
Yes. When multiple claims involve the same payer and context, we can coordinate the negotiation process to reduce duplicative back-and-forth.
What happens if the payer doesn't agree during negotiation?
Open Negotiation is a required step under the No Surprises Act. We ensure this step is completed correctly and documented so the claim is not compromised by missed requirements or deadlines. You will then be ready and have everything you need for initiating your IDR with the arbitrator.
Is this available to billing companies?
Yes. Billing teams can start with the biller intake path so we can coordinate directly with your staff.
Ready for NSA/IDR negotiation support?
Tell us who you are and we'll review your claim for Open Negotiation eligibility.
Start as ProviderWe handle claim information in accordance with HIPAA and applicable federal requirements.