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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:
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
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.
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