Ohio § 3901.38 Prompt payments to health care providers definitions

Ohio Statutes

§ 3901.38 — Prompt payments to health care providers definitions

Ohio § 3901.38

Title 39Insurance

Ch. 3901Superintendent Of Insurance

This text of Ohio § 3901.38 (Prompt payments to health care providers definitions) is published on Counsel Stack Legal Research, covering Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ohio Rev. Code Ann. § 3901.38 (2026).

Text

As used in this section and sections3901.381to3901.3814of the Revised Code:

(A)"Beneficiary" means any policyholder, subscriber, member, employee, or other person who is eligible for benefits under a benefits contract.

(B)"Benefits contract" means a sickness and accident insurance policy providing hospital, surgical, or medical expense coverage, or a health insuring corporation contract or other policy or agreement under which a third-party payer agrees to reimburse for covered health care or dental services rendered to beneficiaries, up to the limits and exclusions contained in the benefits contract.

(C)"Hospital" has the same meaning as in section3727.01of the Revised Code.

(D)"Provider" means a hospital, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor, o

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As used in this section and sections3901.381to3901.3814of the Revised Code:

(A) "Beneficiary" means any policyholder, subscriber, member, employee, or other person who is eligible for benefits under a benefits contract.

(B) "Benefits contract" means a sickness and accident insurance policy providing hospital, surgical, or medical expense coverage, or a health insuring corporation contract or other policy or agreement under which a third-party payer agrees to reimburse for covered health care or dental services rendered to beneficiaries, up to the limits and exclusions contained in the benefits contract.

(C) "Hospital" has the same meaning as in section3727.01of the Revised Code.

(D) "Provider" means a hospital, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor, or other health care provider entitled to reimbursement by a third-party payer for services rendered to a beneficiary under a benefits contract.

(E) "Reimburse" means indemnify, make payment, or otherwise accept responsibility for payment for health care services rendered to a beneficiary, or arrange for the provision of health care services to a beneficiary.

(F) "Third-party payer" means any of the following:

(1) An insurance company;

(2) A health insuring corporation;

(3) A labor organization;

(4) An employer;

(5) An intermediary organization, as defined in section1751.01of the Revised Code, that is not a health delivery network contracting solely with self-insured employers;

(6) An administrator subject to sections3959.01to3959.16of the Revised Code;

(7) A health delivery network, as defined in section1751.01of the Revised Code;

(8) Any other person that is obligated pursuant to a benefits contract to reimburse for covered health care services rendered to beneficiaries under such contract.