IDR & the NSA For provider groups
The 30-Day Open Negotiation Period: The Step You Can't Skip Before IDR
Short answer: you can’t go straight to IDR. The No Surprises Act requires a 30-business-day open negotiation period first, and you must initiate IDR within four business days after it ends. The federal portal enforces these dates — get them wrong and the dispute is blocked before it starts.
The two deadlines that matter
- 30 business days of open negotiation, started by sending an open negotiation notice to the plan.
- 4 business days after that period ends to initiate IDR.
The IDR portal checks the math: if your open-negotiation start date isn’t at least 31 days before submission, it won’t let the dispute proceed.
You don’t need the plan to cooperate
Open negotiation requires that the period be initiated and run — not that the plan engages or agrees. Plan non-response is common. If the 30 business days pass without resolution, you can move to IDR. Silence from the plan is not a roadblock.
Why the dates are the whole game
This step is procedural, but it’s unforgiving. A missed or mis-dated notice doesn’t weaken your case — it removes your right to bring it. The window is short, the portal is strict, and there’s no merits review to fall back on.
How Equavis helps
Equavis sends and timestamps open negotiation notices, then tracks both deadlines per claim so disputes are initiated inside the four-business-day window — not blocked at the portal over a date.
Frequently asked questions
What is the open negotiation period?
Before initiating federal IDR, the provider and plan must go through a 30-business-day open negotiation period, started by sending an open negotiation notice. It's a required step under the No Surprises Act — IDR can only begin after this period has been initiated and has run.
How long do I have to start IDR after open negotiation ends?
Federal IDR must be initiated within four business days after the end of the 30-business-day open negotiation period. The IDR portal checks these dates: if the open-negotiation start date isn't at least 31 days before submission, it blocks the dispute from proceeding.
What happens if the plan never responds to open negotiation?
Open negotiation only requires that the period be initiated and run its course — it does not require the plan to engage or agree. If the 30 business days pass without a resolution, you can proceed to initiate IDR. Plan non-response is common and does not prevent you from moving forward.