Sec. 1. (a) This section applies only to claims submitted for payment by nursing facilities.

     (b) The office shall pay, deny, or suspend each claim submitted by a provider for payment under the Medicaid program not more than:

Terms Used In Indiana Code 12-15-13-1

  • clean claim: means a claim submitted by a provider for payment under the Medicaid program that can be processed without obtaining additional information from:

    Indiana Code 12-15-13-0.5

  • office: includes the following:

    Indiana Code 12-15-13-0.4

(1) twenty-one (21) days after the date a claim that is filed electronically; or

(2) thirty (30) days after the date a claim that is filed on paper;

is received by the office or, if IC 12-15-30 applies, by the contractor under IC 12-15-30.

     (c) The office shall pay each clean claim.

     (d) The office may deny or suspend a claim that is not a clean claim. If the office denies a provider’s claim for payment, the office shall notify the provider of each reason the claim was denied.

     (e) If the office suspends a provider’s claim for payment under the Medicaid program, the office shall notify the provider of each reason the claim was suspended.

[Pre-1992 Revision Citation: 12-1-7-16.5.]

As added by P.L.2-1992, SEC.9. Amended by P.L.10-1994, SEC.4; P.L.107-1996, SEC.5; P.L.257-1996, SEC.5.