Indiana Statutes
§ 12-15-12-13 — Permitted forms
(a)The office and an entity with which the
office contracts for the payment of claims shall accept claims submitted
on any of the following forms by an individual or organization that is
a contractor or subcontractor of the office:
(1)CMS-1500.
(2)CMS-1450 (UB-04).
(3)American Dental Association (ADA) claim form.
(4)Pharmacy and compound drug form.
(b)The office and an entity with which the office contracts for the
payment of claims:
(1)may designate as acceptable claim forms other than a form
listed in subsection (a); and
(2)may not mandate the use of a crossover claim form.
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Legislative History
As added by P.L.256-2001, SEC.2. Amended by P.L.208-2018,
SEC.3.
Nearby Sections
15
§ 12-10-1-1
Establishment of bureau§ 12-10-1-2
Purpose§ 12-10-1-3
Administration of programs§ 12-10-1-4
Duties§ 12-10-1-5
Coordination of services with area agencies§ 12-10-1-6
Area agencies; duties; coverage area changes§ 12-10-10-1
"Case management"§ 12-10-10-1.5
"Activities of daily living"§ 12-10-10-10
Services funding; source§ 12-10-10-12
Negotiation of reimbursement rates§ 12-10-10-2
"Community and home care services"