The open negotiation notice starts the clock on every No Surprises Act dispute. Send it late, or send it wrong, and the claim can never reach IDR. Here is exactly how it works.
Under the No Surprises Act, before either party can initiate federal IDR, the parties must go through a 30-business-day open negotiation period. The period begins when one party sends the other a written open negotiation notice — CMS publishes a standard form (the "Open Negotiation Notice") that satisfies the content requirements. Either party can send it; in practice the provider almost always does.
Within 30 business days of receiving the plan's initial payment or notice of denial for the item or service. Business days exclude weekends and federal holidays. Day one is the business day after the initial payment/denial is received.
Use the CMS standard notice; the plan is required to accept it in the manner it has designated (typically email or portal). Keep proof of the date sent.
The negotiation period runs from the day the notice is sent, not received.
The plan may respond with an offer or ignore it. If you agree on a rate, the dispute is settled and no IDR fees are incurred.
If no agreement, you may proceed to federal IDR — but only within the next window.
You must submit the Notice of IDR Initiation in the federal portal within 4 business days after the negotiation period ends. Missing this window forfeits the claim.
Enter the date of the payer's initial payment or denial. Business days exclude weekends and federal holidays.
Guidance only — the statutory clocks are counted in business days and can be affected by the date a payer receives a clean claim, weekends, and holidays. We verify every deadline claim by claim before filing.
Send us a sample of recent OON remits. We'll tell you which claims are IDR-eligible, what similar disputes have paid, and what we'd file. No fee unless we win you more.
Request a free eligibility review