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.
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| The prompt pay law does not apply to Medicare,
Medicaid or self-insured ERISA plans. Click here for
the types of claims covered. |
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| 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. |
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