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Prompt Pay Complaints

Prompt Pay Complaints

Filing a Complaint 

Pharmacists filing complaints against Pharmacy Benefit Managers (PBMs), please click here to access the appropriate form.
​A consumer or insured individual may file a complaint with the Ohio Department of Insurance's Office of Consumer Services. 

Prompt Pay

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

The department has developed two online provider complaint processes; one for Prompt Pay and the other for Credentialing and Contract Complaints. 

Credentialing and Contract Complaint

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

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. 

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