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Prompt Payment Reporting

Insurers offering health benefit plans must submit reports to the Department of Consumer and Business Services about their compliance regarding claims they received from a provider on behalf of an enrollee. Data must be reported by March 1 for the preceding calendar year, in accordance with OAR 836-080-0085.

Refer to ORS 743B.450 and OAR 836-080-0085 for additional details, including who must report.

General directions

  1. Use Form 440-3431 to complete the initial reporting requirement.

  2. Report each claim for which a claim number was assigned and an initial final determination was made during the reporting period. Each claim should only be reported one time. Do not include credits/adjustments. Include only claims related to health benefit plan business.

  3. Reported claims shall include only those claims for which final disposition has been made by the insurer during the immediately preceding calendar year, even if said claims were received before the immediately preceding calendar year.

  4. A population list of all claims finally disposed of later than the 30th day after the date on which the insurer received them must accompany the reporting form. This list must be a text (.txt) or spreadsheet (.xlsx, .csv) file. For each claim, include the claim number and date the claim was received.

  5. Submit Form 440-3431 and the population list (if applicable) through SERFF using the TOI (type of insurance) “Annual Required Reports" and sub-TOI “Prompt Pay." Alternatively, submissions can be emailed to DFR.DataTeam@dcbs.oregon.gov. If preferred, DFR staff can initiate a secure message for submission of this information.