Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities and Providers of Air Ambulance Services
No Surprises Act: IDR Process
Notice of Agreement 10.23.23_clean
Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities and Providers of Air Ambulance Services
OMB: 1210-0169
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1210-0169 can be found here: