§ 12-15-13-1.6 — Payment, denial, or suspension of claims; notice of suspension or denial

Indiana § 12-15-13-1.6

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 13: Provider Payment; General

Text

6. (a) This section does not apply to claims
submitted for payment by nursing facilities.
(b) The office shall pay or deny each clean claim in accordance with
section 1.7 of this chapter.
(c) The office shall deny or suspend each claim that is not a clean
claim in accordance with subsection (d).
(d) The office shall deny or suspend each claim that is:
(1) not a clean claim; and
(2) submitted by a provider for payment under the Medicaid
program;
not more than thirty (30) days after the date the claim is received by the
office or, if IC 12-15-30 applies, by the contractor under IC 12-15-30.
(e) If the office denies a provider's claim for payment under
subsection (d) or section 1.7 of this chapter, the office shall notify the
provider of each reason the claim was denied.
(f) If the office suspends a provider's claim for payment under
subsection (d), the office shall notify the provider of each reason the
claim was suspended.

Legislative History

As added by P.L.107-1996, SEC.7 and P.L.257-1996, SEC.7.