Halo & NSA
This law protects patients from surprise medical bills.
What is the No Surprises Act?
IDR stands for this.
What is Independent Dispute Resolution?
This form is a Halo-generated form that comes in a electronic format.
What is an 835?
This is the search mechanism to search for a claim number.
What is the custom button?
This is highlighted in gold in Arbit.
What is a bifurcated state?
Halo’s four brand commitments include Consistent, Memorable, Engaging, and this word.
What is Committed?
The neutral third party in IDR is called this.
What is the IDRE?
This claim form is used for inpatient hospital or facility billing and includes revenue codes
What is a UB-04 (CMS-1450)?
This Arbit section contains uploaded briefs, EOBs, and supporting documentation.
What is the Documents and Files section?
This plan type is typically regulated at the state level.
What is a fully insured plan?
This phase happens before a dispute goes into the Federal IDR process.
What is Open Negotiation?
Open Negotiation lasts this many business days before a party can file for Federal IDR.
What is 30 business days?
This form is typically used to bill professional services such as physicians, NPs, or outpatient providers
What is a CMS-1500?
This required federal document identifies the provider, payor, patient, and designated representatives in an IDR case.
What is the Information on Parties form?
This term refers to a state choosing to choosing to accept Self-funded plans.
What is "Opt In"?
This federal agency oversees the IDR process and issues NOOF documents.
What is CMS?
After Open Negotiation ends, a party has this many business days to initiate the Federal IDR process.
What is 4 business days?
This section of an EOB explains why a claim was reduced, denied, or adjusted.
What are Remark Codes?
This document appears in Arbit once CMS generates it.
What is the NOOF?
What is a non-bifurcated state?
This NSA protection applies specifically to emergency services and certain out-of-network services provided at in-network facilities.
What is balance billing protection?
After the IDRE is selected, both parties have this many business days to submit their offers and supporting documentation
What is 10 business days?
In the IDR process, the EOB is used to verify the date of this critical event, which starts the Open Negotiation timeline.
What is the Initial Payment (or Denial)?
You can locate the IDRE on this page.
What is the dispute page?
One factor that determines whether what pathway the case falls under.
What is where the care was given? What is the state the care was given?