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. In addition, the law requires (health insurers, third-party payers, health insuring corporations, and third-party administrators) to inform healthcare providers of routinely required information; to establish a claim status check system; and to pay interest on late claims. The law establishes notice requirements and certain limitations on the recovery of overpayments.
Providers may file a prompt pay complaint by clicking here. The Department may not be able to investigate and resolve individual complaints. However, the department monitors complaint activity and collects and analyzes other data to monitor claim-handling practices.
The prompt pay law does not apply to Medicare, Medicaid or self-insured ERISA plans. Click here for the types of claims covered.
Reimbursement Matters such as rates established by third-party payers are deemed to be private contractual terms between the provider and the third-party payer, which means we do not have authority to resolve your complaint. The Department’s jurisdiction over insurance matters is governed by what is set forth in Title 39 of the Ohio Revised Code (“R.C.”), which we must follow.
Ohio's Prompt Pay Law
Provider Complaint Unit
Ohio Department of Insurance
50 W. Town Street
Third Floor - Suite 300
Columbus, Ohio 43215
Phone: 1-800-686-1526
Fax: (614) 644-3744 |