Consumer Complaint Form
The Ohio Department of Insurance Consumer Services Division provides consumer information and investigates complaints against companies or agents involving all kinds of insurance. Click here to access the consumer complaint form.
Pharmacy Benefit Manager Complaint Form
The Consumer Services Division of the Ohio Department of Insurance provides information and investigates complaints involving pharmacy benefit managers
, pursuant to Ohio Revised Code 3959. To file a complaint click here
Understanding the Health Coverage and External Review Appeals Processes
The Ohio Department of Insurance has created this on-line toolkit
to help consumers and medical providers understand the process by which they can appeal a health coverage claim denial made by their insurer after the appeals process with the insurer has been exhausted. The toolkit contains a helpful brochure, articles, and answers to frequently asked questions. Those with questions about appealing their insurer's health coverage decisions can call the Department's consumer hotline at 1-800-686-1526. Click here to file a complaint to start an appeal.
Enforcement Complaint Form
The Enforcement Unit investigates allegations of illegal conduct by insurance agents and agencies. Click here
to file an enforcement complaint.
Fraud Complaint Form
The Fraud Unit will investigate complaints of persons suspected of fraudulently attempting to receive a benefit from an insurance company. Click here
to file a fraud complaint.
Provider Complaint Options
The department has developed two online provider complaint processes; one for Prompt Pay and the other for Credentialing and Contract Complaints.
- A healthcare provider may submit a prompt pay complaint to the department by completing the online Prompt Pay Complaint Form. A provider should follow all contract grievance and appeal procedures before filing the complaint.
- If you are unable to use the online form, please download and complete the Prompt Pay Complaint Form (pdf version).
Credentialing & Contract
- Providers may 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 click here to access and complete the online Credentialing & Contract Complaint Form.
- If you are unable to use the online form, please download and complete the Credentialing & Contract Complaint Form (pdf version).