§ 27-1-46-12 — In network good faith estimates; out of network good faith estimates

Indiana § 27-1-46-12

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 1: DEPARTMENT OF INSURANCE
• Ch. 46: Provider Facility Good Faith Estimates

Text

(a) If:
(1) the individual who requests a good faith estimate from a
provider facility under this chapter and has been verified as a
covered individual with respect to a network plan; and
(2) the provider facility from which the individual requests the
good faith estimate is in network with respect to the same network
plan;
the good faith estimate that the provider facility provides to the
individual under this chapter must be based on the price to which the
provider facility and any practitioners referred to in section 11(c)(2) of
this chapter have agreed as in network providers.
(b) If the individual who requests a good faith estimate from a
provider facility under this chapter:
(1) is not a covered individual with respect to any network plan;
or
(2) is not a covered individual with respect to a network plan with
respect to which the provider facility is in network;
the good faith estimate that the provider facility provides to the
individual under this chapter must be based on the price that the
provider facility and any practitioners referred to in section 11(c)(2) of
this chapter charge for the nonemergency health care services in the
absence of any network plan.

Legislative History

As added by P.L.93-2020, SEC.12.