Indiana Code 12-15-29-7. Notice to insurer that Medicaid has been furnished; requirements; notification given office by insurer; payment of claim
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Sec. 7. (a) The notice requirements of section 4 of this chapter are satisfied if:
(2) the insurer receives a claim from a beneficiary stating that the beneficiary has applied for or has received Medicaid from the office in connection with the same claim.
(1) the insurer receives from the office, electronically or by United States mail, a statement of the claims paid or medical services rendered by the office, together with a claim for reimbursement; or
Terms Used In Indiana Code 12-15-29-7
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- insurer: includes a pharmacy benefit manager. See Indiana Code 12-15-29-0.5
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
(b) An insurer that receives a claim under subsection (a)(2) shall notify the office of the insurer’s obligation on the claim and shall:
(1) pay the obligation to the provider of service; or
(2) if the office has provided Medicaid, pay the office.
[Pre-1992 Revision Citation: 12-1-7-24.2(d).]
As added by P.L.2-1992, SEC.9. Amended by P.L.187-2007, SEC.6.