Privacy notices for consumers & professionals

Privacy notices for consumers & professionals

This page contains notices and website privacy policies for the forms and data collections supporting surprise billing protections and complaints.

Consumer complaints:

Consumers initiating patient-provider dispute resolution:

  • Website privacy policy for the payment dispute forms for consumers download (PDF)

Providers responding to patient-provider dispute resolution:

  • Website privacy policy for the provider forms for patient dispute resolution download (PDF)

Disputing parties to federal independent dispute resolution:

  • Website privacy policy for the disputing party forms for federal independent dispute resolution download (PDF)

Provider complaints:

  • Website privacy policy for the provider billing complaints download (PDF)
Page Last Modified:
09/15/2023 01:09 PM