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43 chapters · 1,367 sections in this title.
Ohio Rev. Code Ann. § 3922.01 Definitions
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As used in this chapter: (A) "Adverse benefit determination" means a decision by a health plan issuer:(1) To deny, reduce, or terminate a requested health care service or payment in whole or in part, including all of the following:(a) A determination that the health care service …
Ohio Rev. Code Ann. § 3922.02 Request for review of adverse benefit determination
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(A) A covered person may make a request for an external review of an adverse benefit determination. (B) All requests for external review shall be made in writing, including by electronic means, by the covered person to the health plan issuer within one hundred eighty days of the …
Ohio Rev. Code Ann. § 3922.03 Internal appeal processes; review of final determination
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(A) All health plan issuers shall implement an internal appeal process under which a covered person may appeal an adverse benefit determination. This process must be in compliance with the "Patient Protection and Affordable Care Act of 2010," Pub. L. 111-148, 124 Stat. 119, as am…
Ohio Rev. Code Ann. § 3922.04 Exhaustion of issuer's internal appeal process
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(A) Except as provided in division (E) of this section, a health plan issuer is not required to grant a request for a standard external review made under section 3922.08 or 3922.10 of the Revised Code until the covered person has exhausted the health plan issuer's internal appeal…