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Provider Complaint Options

Provider Links
Prompt Payment Law
Time Frames for Claims
Claim Processing
Complaint Form
Claims Covered by Law
Agency Contacts
Mental Health Parity Toolkit
Starting an appeal
HB 125/ CAQH Credentialing Application
Prompt Pay Frequently Asked Questions
Have Prompt Pay Complaint Questions? Email us here

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Filing a Complaint
 
A consumer or insured may file a complaint with the Department's Office of Consumer Services.
 
Prompt Pay

A healthcare provider may submit a prompt pay complaint to the Ohio Department of Insurance by completing the Prompt Pay Complaint Form. A provider should follow all contract grievance and appeal procedures before filing a complaint with the Department.

Instructions for Using the Online Provider Complaint Systems

The Department has developed two online provider complaint processes; one for Prompt Pay and the other for Credentialing and Contract Complaints. To access detailed instructions on the process for submitting and/or responding to provider complaints on these systems please select:

Complaint Submission Instructions (for Providers)

Credentialing & Contract Complaint 

There is also an option for providers to file complaints pertaining to credentialing & contractual matters. This is a process established due to recent enactment of legislation to address these issues (HB 125). Please select Credentialing & Contract Complaint Form.

Responding to a Complaint

 

Prompt Pay and Credentialing & Contract Complaint

The Department will forward provider complaints to the third-party payers for a response. The third-party payer will be directed to resolve the complaint directly with the provider. The third-party payer will notify the Department of the resolution of the complaint. Complaint Resolution Instructions (for Third-Party Payers).


Click here for the third-party payer's Prompt Pay Response Form.

Click here for the third-party payer's Credentialing and Contract Complaint Response Form.

Frequently Asked Questions about Ohio's prompt payment laws and online complaint system

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 | Mary Taylor, Lt. Governor / Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | OSHIIP Hotline: 800-686-1578