Indiana § 27-8-11-13.5 Provisional credentialing for physicians; conditions

Indiana Statutes

§ 27-8-11-13.5 — Provisional credentialing for physicians; conditions

Indiana § 27-8-11-13.5

Title 27INSURANCE

Art. 8LIFE, ACCIDENT, AND HEALTH

Ch. 11Accident and Sickness Insurance─Reimbursement

This text of Indiana § 27-8-11-13.5 (Provisional credentialing for physicians; conditions) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 27-8-11-13.5 (2026).

Text

5.

(a)As used in this section, "physician" refers to an individual who:

(1)is licensed under IC 25-22.5;

(2)has been granted reciprocity by the medical licensing board of Indiana under IC 25-1-21 before July 1, 2026; or

(3)is licensed in a state that has enacted the interstate medical licensure compact.

(b)If a physician who is fully credentialed by an insurer:

(1)leaves the employment of an employer and becomes employed with another employer in Indiana; or

(2)establishes or relocates a medical practice in Indiana; the insurer shall provisionally credential the physician for the time frame set forth in subsection (c).

(c)A physician under subsection (b) must be provisionally credentialed:

(1)for sixty (60) days after the physician's separation from employment or the establishment

Free access — add to your briefcase to read the full text and ask questions with AI

5. (a) As used in this section, "physician"
refers to an individual who:
(1) is licensed under IC 25-22.5;
(2) has been granted reciprocity by the medical licensing board of
Indiana under IC 25-1-21 before July 1, 2026; or
(3) is licensed in a state that has enacted the interstate medical
licensure compact.
(b) If a physician who is fully credentialed by an insurer:
(1) leaves the employment of an employer and becomes employed
with another employer in Indiana; or
(2) establishes or relocates a medical practice in Indiana;
the insurer shall provisionally credential the physician for the time
frame set forth in subsection (c).
(c) A physician under subsection (b) must be provisionally
credentialed:
(1) for sixty (60) days after the physician's separation from
employment or the establishment or relocation of the medical
practice; or
(2) until the physician is fully credentialed by the insurer;
whichever is earlier.
(d) Notwithstanding section 7(k) of this chapter, an insurer shall
reimburse a physician who is provisionally credentialed under this
section for services rendered while the physician was provisionally
credentialed at the rates determined by:
(1) the agreement between the physician's new employer and the
insurer under section 3 of this chapter; or
(2) if:
(A) the physician's new employer has not entered into an
agreement with the insurer under section 3 of this chapter; or
(B) the physician established or relocated a medical practice;
the agreement between the physician and the insurer under
section 3 of this chapter that was in effect at the time of the
physician's separation from employment or the establishment or
relocation of the medical practice.