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Types of claims that are covered by the prompt pay law
Ohio's prompt pay law is found in sections 3901.38-3901.3814 of the Revised Code and it applies to claims submitted to a health insurer, or health Insuring Corporation (third-party payer) from a provider or insured (beneficiary). Claims must be submitted on the standard claim form prescribed in rule 3901-1-59.
The Ohio prompt pay law does not apply to claims submitted pursuant to Medicaid, Medicare or Self-funded ERISA plans. For Medicaid claims, please contact the Ohio Department of Jobs and Family Services. For Medicare claims, please contact the Centers for Medicare and Medicaid Services. For Self-funded ERISA claims, please contact the United States Department of Labor. For individual contact information check these agencies.