§ 27-4-10-10 — No requirement to accept virtual claim payment; requirements; fees; waiver of requirements prohibited; violations

(a) A health insurance plan may not require
a dental provider to accept payment under the health insurance plan by
virtual claim payment.
(b) Before an initial payment to a dental provider using an electronic
funds transfer payment, including a virtual claim payment, or before
modifying the method of payment, a health insurer or contracted
vendor of a health insurer shall:
(1) notify the dental provider of any fees associated with the
electronic funds transfer payment other than the fees imposed by
the dental provider's financial institution; and
(2) concerning a virtual claim payment, advise the dental provider
of the methods of payment available under the health insurance
plan and provide clear instructions to the dental provider as to
how to select an alternate payment method.
(c) A health insurer or contracted vendor of a health insurer may not
charge a fee to a dental provider solely for transmitting an Automated
Clearing House Network payment to the dental provider, unless the
dental provider has consented to the fee. A provider billing agent may
charge a reasonable fee to a dental provider for transmitting an
Automated Clearing House Network payment as part of a fee charged
by the provider billing agent for transaction management, data
management, portal services, and other value added services in
addition to the payment transmission that are provided by the provider
billing agent to the dental provider.
(d) The provisions of this section may not be waived by contract,
and any contractual clause that conflicts with the provisions of this
section or that purports to waive any requirement of this section is void.
(e) Violation of this section is an unfair or deceptive act or practice
in the business of insurance that is subject to enforcement by the
commissioner under IC 27-4-1.

Legislative History

As added by P.L.31-2021, SEC.4.