No Surprises Act
Forms and resources
- Open negotiation notice
- Notice of IDR initiation
- Capital Blue Cross No Surprises Act frequently asked questions
- The Federal Independent Dispute Resolution Process frequently asked questions
When submitting an open negotiation or independent dispute resolution (IDR) request form, please include the following key elements:
- Claim number
- Provider first and last name (professional providers)
- Provider group name (professional providers)
- Facility name (facility providers)
- Provider NPI
- Plan name
- Member first and last name