CMS Opens Online Portal for Disputed Claims under the No Surprises Act

April 21, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced the opening of an online portal to be used for the Independent Dispute Resolution Process (IDR) under the No Surprises Act.

Providers who were involved in an open negotiation process that expired prior to the opening of the portal can initiate the IDR process until May 6. For claims currently in the open negotiation period, providers will continue to follow the normal timeline of initiation of the IDR process within four business days of the expiration of the open negotiation period.

To initiate a dispute through the portal, CMS requires the following: 

• Information to identify the qualified IDR items or services 
• Dates and location of items or services 
• Type of items or services such as emergency services and post-stabilization services 
• Codes for corresponding service and place-of-service 
• Attestation that items or services are within the scope of the Federal IDR process 
• The initiating party’s preferred certified IDR entity. 

For additional information please view the No Surprises Act Toolkit, which was recently released by the AMA. The Toolkit outlines the payment process and can be used by providers or facilities. The toolkit can be accessed here.