§ 5-10-8.1-6 — Notice of deficiencies in claims

Indiana § 5-10-8.1-6

• Jurisdiction: Indiana
• Title 5: STATE AND LOCAL ADMINISTRATION
• Art. 10: PUBLIC EMPLOYEE BENEFITS
• Ch. 8.1: State Employee Health Benefits; Provider Payment

Text

(a) The administrator shall pay or deny each
clean claim in accordance with section 7 of this chapter.
(b) An administrator shall notify a provider of any deficiencies in a
submitted claim not more than:
(1) thirty (30) days for a claim that is filed electronically; or
(2) forty-five (45) days for a claim that is filed on paper;
and describe any remedy necessary to establish a clean claim.
(c) Failure of an administrator to notify a provider as required under
subsection (b) establishes the submitted claim as a clean claim.

Legislative History

As added by P.L.162-2001, SEC.1. Amended by P.L.137-2002, SEC.1.