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Prompt Pay Data Call

Prompt Pay Data Call

The Prompt Pay Data Call application allows insurance companies doing business in Ohio to file their Department of Insurance (ODI)-required claims payment processing data online. 

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. The purpose of the semi-annual Prompt Pay Data Call is to measure companies' compliance with Ohio's Prompt Payment Law.

Pursuant to Ohio Revised Code 3901.3811, data is collected semi-annually as indicated below:

Quarter

Data Period

Reporting Window

Due Date

1st

1/1 - 3/31

4/1 - 4/30

4/30

3rd

7/1 - 9/30

10/1 - 10/31

10/31

Who Should Use This Application

Only insurance companies filing their claims payment processing data should access this application. In order to receive a new account, you must represent an insurance company that has health business in Ohio during the current reporting period. 

The company's staff member(s) who will submit the filing for the Prompt Pay Data Call must have an individual OH|ID account.   If the person submitting this report already has an OH|ID account, there is no need to sign up for a new one, instead follow the instructions to request access to this application. If you have an OH|ID account and already have access to this application, log in to the OH|ID PORTAL to get started.

Upon receipt of an electronic application for an OH|ID account, the department will send a confirmation e-mail to the applicant. To finalize the account registration process, it will be necessary to access a link included within the confirmation e-mail.

Business Lines Categories

The department has identified the data to be reported according to statute. Four general business line categories that are further defined by more specific business lines (subcategories or business lines) within each general category are required for reporting purposes. Companies must report prompt pay data only for the subcategories for which they write business.

Individual - Health Insurance

  • Medical (Comprehensive, Individual, Conversion, Open Enrollment, Franchise Blanket Accident & Sickness, and Short Term Medical
  • Supplemental Coverage (Dental, Hosp./Surg./Outpatient Ind., Rx, Specified/Named Disease/Intensive Care/Organ & Tissue Transplant, Vision)
  • Senior Coverage (Medicare Supplement)
  • Miscellaneous (Accident Only, Student Policies - Accident & Health)

Group/Blanket Policy - Health Insurance

  • Medical (Comprehensive, Large Group, Small group, Non-employer Group, Alliance, Franchise/Blanket Accident & Sickness, and Short Term Medical)
  • Supplemental Coverage (Dental, Hosp./Surg./Outpatient Ind., Rx, Specified/Named Disease/Intensive Care/Organ & Tissue Transplant, Vision)
  • Senior Coverage (Medicare Supplement)
  • Miscellaneous (Accident Only, Student Policies – Accident & Health)

Non-Group - Health Insuring Corporation (HIC)

  • Medical (Comprehensive, Individual, Conversion, Open Enrollment)
  • Supplemental Coverage (Dental, Rx, Short Term Care, Vision, Mental Health)

Group - Health Insuring Corporations (HIC)

  • Medical (Comprehensive, Large Group, Small Group, Non-employer Group, Small Employer Health Care Alliance, Alliance)
  • Supplemental/Specialty Plans (Dental, Rx, Short Term Care, Vision, Mental Health)

Contact Information

For questions about your Prompt Pay Data Call filings, or if you need assistance with your account information, please email PPRDC@insurance.ohio.gov.