Ohio § 3901.383

§ 3901.383.

(A) A provider and a third-party payer may do either of the following: (1) Enter into a contractual agreement under which time periods shorter than those set

forth in section 3901.381 of the Revised Code are applicable to the third-party payer in paying a claim for any amount due for

health care services rendered by the provider; (2) Enter into a contractual agreement under which the timing of payments by the third-party

payer is not directly related to the receipt of a claim form.  The contractual arrangement may include periodic interim payment arrangements, capitation

payment arrangements, or other periodic payment arrangements acceptable to the provider

and the third-party payer.  Under a capitation payment arrangement, the third-party payer shall begin paying

the capitated amounts to the beneficiary's primary care provider not later than sixty

days after the date the beneficiary selects or is assigned to the provider.  Under any other contractual periodic payment arrangement, the contractual agreement

shall state, with specificity, the timing of payments by the third-party payer. (B) Regardless of whether a third-party payer is exempted under division (D) of section

3901.3814 from sections 3901.38 and 3901.381 to 3901.3813 of the Revised Code , a provider and the third-party payer, including a third-party payer that provides

coverage under the medicaid program, shall not enter into a contractual arrangement

under which time periods longer than those provided for in paragraph (c)(1) of 42 C.F.R. 447.46 are applicable to the third-party payer in paying a claim for any amount due for

health care services rendered by the provider.