{"data":{"id":"us-oh/ohio-rev.-code-3901.387","jurisdiction":"us-oh","citation":"Ohio Rev. Code § 3901.387","heading":"Duplicative claims - claim information system.","body":"(A) When a provider or beneficiary submits a duplicative claim for payment for health care services before the time periods specified in section 3901.381 of the Revised Code have elapsed for the original claim submitted, the third-party payer may deny the duplicative claim. Denials of claims determined to be duplicative by the department of insurance shall not be considered by the department in a market conduct examination of a third-party payer's compliance with section 3901.381 of the Revised Code. The superintendent of insurance shall have the discretion to exclude an original claim in determining a violation under section 3901.381 of the Revised Code.\n(B)(1) A third-party payer shall establish a system whereby a provider and a beneficiary may obtain information regarding the status of a claim for payment for health care services, provided the claim is not materially deficient. A third-party payer shall inform providers and beneficiaries of the mechanisms that may be used to gain access to the system.\n(2) If a third-party payer delegates the processing of payments to another entity, the third-party payer shall require the entity to comply with division (B)(1) of this section on behalf of the third-party payer.","path":["Title 39 Insurance","Chapter 3901 Superintendent Of Insurance"],"source_url":"https://codes.ohio.gov/ohio-revised-code/section-3901.387","current_through":"2002-07-24 (Senate Bill 4 - 124th General Assembly)","vintage":"","retrieved_at":"2026-09-14T19:24:35Z","sha256":"07887f5286366dc7916a40db1bb17752cd01d5e8dc5c1d953f440cd6b7f5e215","source_id":"us-oh","stale":false,"prev":"us-oh/ohio-rev.-code-3901.386","next":"us-oh/ohio-rev.-code-3901.388"},"notice":"GroundRules: Original legal text. Not legal advice."}