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Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities
No Surprises Act: IDR Process
14. Online PPDR Initiation Form
Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities
OMB: 1210-0169
OMB.report
DOL/EBSA
OMB 1210-0169
ICR 202302-1210-003
IC 252194
Federal IDR Process for Services relating to Nonparticipating Providers or Nonparticipating Emergency Facilities
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1210-0169 can be found here:
2023-11-03 - Revision of a currently approved collection
2023-02-24 - RCF Recertification
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2023-08-20
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