Source: OhioHealth Government Relations Newsletter April 2022
Ohio’s surprise billing law permits a physician or other health care provider to initiate negotiations with a health insurer in lieu of accepting the initial reimbursement amount.
As a first step, the parties have 30 days to negotiate an out-of-network reimbursement rate. If still at an impasse, a provider has the right to seek arbitration and the parties can also engage with their arbitration process through the state’s arbitration portal.
Cases eligible for arbitration can be no more than one-year-old and the billed amount must exceed $750. Claims may be bundled according to exact billing codes to get to the $750 threshold.
- The main surprise billing landing page, where the link to the arbitration portal is displayed
- The arbitration portal.
Relatedly, the federal government has issued FAQ’s on the federal No Surprises Act.