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Prompt Pay Data Call

The Ohio Department of Insurance is committed to assuring the prompt processing and payment of healthcare claims. Ohio's Prompt Pay law establishes strict time frames for the processing and payment of claims. The purpose of the semi-annual Prompt Pay Data Call is to measure companies' compliance with Ohio's Prompt Payment Law.

Pursuant to Ohio Revised Code 3901.3811, data is collected semi-annually as indicated below:
QUARTER
DATA PERIOD
REPORTING WINDOW
DUE DATE
1st
1/1 – 3/31
4/1 – 4/30
5/1
3rd
7/1 – 9/30
10/1 – 10/31
11/1
 
 
Business Lines/Categories:
 

The Ohio Department of Insurance (ODI) has identified the data to be reported according to statute. Four (4) general business line categories that are further defined by more specific business lines (subcategories or business line) within each general category are required for reporting purposes. Companies must report prompt pay data only for the subcategories for which they write business.  The business line categories are:

 
Individual – Health Insurance:
  • Medical (Comprehensive, Individual, Conversion, Open Enrollment, Franchise Blanket Accident & Sickness, and Short Term Medical)
  • Supplemental Coverage (Dental, Hosp./Surg./Outpatient Ind., Rx, Specified/Named Disease/Intensive Care/Organ & Tissue Transplant, Vision)
  • Senior Coverage (Medicare Supplement)
  • Miscellaneous (Accident Only, Student Policies - Accident & Health) 

 

Group/Blanket Policy – Health Insurance:

  • Medical (Comprehensive, Large Group, Small group, Non-employer Group, Alliance, Franchise/Blanket Accident & Sickness, and Short Term Medical)
  • Supplemental Coverage (Dental, Hosp./Surg./Outpatient Ind., Rx, Specified/Named Disease/Intensive Care/Organ & Tissue Transplant, Vision)
  • Senior Coverage (Medicare Supplement)
  • Miscellaneous (Accident Only, Student Policies – Accident & Health)

 

Non Group – Health Insuring Corporation (HIC):

  • Medical (Comprehensive, Individual, Conversion, Open Enrollment)
  • Supplemental Coverage (Dental, Rx, Short Term Care, Vision, Mental Health) 

 

Group – Health Insuring Corporations (HIC):

  • Medical (Comprehensive, Large Group, Small Group, Non-employer Group, Small Employer Health Care Alliance, Alliance)
  • Supplemental/Specialty Plans (Dental, Rx, Short Term Care, Vision, Mental Health)
 
 
Gateway Account Required:

The company's staff member(s) who will submit the filing for the Prompt Pay Data Call must have an individual Gateway account with the department to do so.  If the person submitting this report already has a Gateway account, there is no need to sign up for a new one, instead follow the instructions to request access to this application. If you have a Gateway account and already have access to this application , log in to the Gateway to get started.
Upon receipt of an electronic application for a Gateway account, the department will send a confirmation e-mail to the applicant. To finalize the account registration process, it will be necessary to access a link included within the confirmation e-mail.

 


The State of Ohio is an Equal Opportunity Employer

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
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John Kasich, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | OSHIIP Hotline: 800-686-1578