NO SURPRISES ACT
Pre-IDR Insurance Negotiation
We manage the required Open Negotiation process under the No Surprises Act — preparing your Open Negotiation Notice (ONN) and handling payer communications so deadlines and requirements aren’t missed.
What We Handle
- Prepare and send the official Open Negotiation Notice (ONN).
- Manage payer responses, counteroffers, and follow-ups.
- Track required timelines and documentation throughout the negotiation period.
Who This Is For
- Out-of-network providers seeking fair payment under the No Surprises Act.
- Billing teams handling NSA negotiation workflows across multiple providers.
- Groups needing a structured process without tracking deadlines manually.
What We Need to Get Started
- Payer name and claim number.
- Date(s) of service and service codes (if available).
- Payment or denial details.
(We may request additional documentation later if needed.)
Why Pre-IDR Negotiation Matters
Under the No Surprises Act, a formal Open Negotiation period is required before a payment dispute can move forward.
- It is not optional.
- It has strict timelines.
- It requires a compliant Open Negotiation Notice (ONN).
- It creates the official negotiation record for the claim.
Even when negotiation does not result in agreement, completing this step correctly is critical to preserving next-step options under the law.
Common Scenarios We See
If any of these sound familiar, Pre-IDR negotiation may apply.
- Out-of-network emergency services paid far below expectations
- OON services at in-network facilities subject to No Surprises Act rules
- Claims where payers delay or ignore negotiation outreach
- Billing teams managing multiple NSA-eligible claims
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 information completeness (same/next business day).
- Step 2Invoice + authorization
We send a simple engagement invoice and authorization to represent you during the Open Negotiation period (typically within 1 business day after eligibility).
- Step 3Open Negotiation with the payer
We prepare the ONN, manage payer communications, and document the negotiation process in line with federal requirements.
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.
We are not a Certified IDR Entity (arbitrator), and we do not make payment determinations. Our role is to manage the negotiation process in a structured, compliant way so requirements and timelines are met.
FAQ
Pre-IDR Negotiation FAQs
How quickly do you send the Open Negotiation Notice (ONN)?
Once we receive complete information and authorization, we aim to send the ONN 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.
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 Pre-IDR negotiation support?
Tell us who you are and we’ll review your claim for Open Negotiation eligibility.
We handle claim information in accordance with HIPAA and applicable federal requirements.