Office of Insurance and Safety Fire CommissionerJohn F. King
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Provider Prompt Pay Inquiry

The Office of Insurance and Safety Fire Commissioner now offers medical providers the opportunity to report instances of delayed medical claims payments to the Department for review. Please complete the Inquiry Form below in as much detail as possible to fully explain your concern for faster review. While the Department has jurisdiction over the majority of health plans offered in Georgia, please note that some plans, such self-insured plans, are outside of our jurisdiction.
Inquirer Info.
First Name: Last Name:
Title: Phone#:
Email: Confirm Email:
Business Name: Business Add1:
Business add2 if any: Business State:
Business City: Business Zip:
Insurance Carrier Info.
Legal Name of Carrier:
Other Carrier Information if any:
Carrier NAIC Number if any:
Claim Number:
Type of Coverage: Fully InsuredSelf Insured Method of Submission: PaperElectronic
Date of Service: Click here to enter date Date of Claim Submission: Click here to enter date
Claim Type: DentalMedicare SupplementComprehensive(hospital and medical)
VisionMedicareFederal Employees Health Benefit Plan
MedicaidOther HealthSelf-Insured (ASO/ASC)
PharmacyAny other claim type not identified above

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