Indiana Code 22-3-7.2-5. Notice of deficiencies in claims
(b) A payor shall notify a medical service provider of any deficiencies in a submitted claim not more than:
Terms Used In Indiana Code 22-3-7.2-5
- clean claim: means a claim submitted by a medical service provider for payment under IC 22-3-2 through IC 22-3-7 that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment. See Indiana Code 22-3-7.2-1
- medical service provider: means a person or an entity that provides services or products to an employee under IC 22-3-2 through IC 22-3-7. See Indiana Code 22-3-7.2-4
- payor: means an employer or an employer's insurance carrier that is liable for a claim for a service or product under IC 22-3-2 through IC 22-3-7. See Indiana Code 22-3-7.2-2
(2) forty-five (45) days after the date the claim is received by the payor, for a claim that is filed on paper;
and describe any remedy necessary to establish a clean claim.
(c) Failure of a payor to notify a medical service provider as required under subsection (b) establishes the submitted claim as a clean claim.
As added by P.L.160-2022, SEC.10.
Indiana Code 22-3-7-2.5. School to work student
(b) A school to work student is entitled to the following compensation and benefits under this chapter:
Terms Used In Indiana Code 22-3-7-2.5
- Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
- disablement: means the event of becoming disabled from earning full wages at the work in which the employee was engaged when last exposed to the hazards of the occupational disease by the employer from whom the employee claims compensation or equal wages in other suitable employment, and "disability" means the state of being so incapacitated. See Indiana Code 22-3-7-9
- occupational disease: means a disease arising out of and in the course of the employment. See Indiana Code 22-3-7-10
(2) Permanent partial impairment compensation under section 16 of this chapter. Permanent partial impairment compensation for a school to work student shall be paid in a lump sum upon agreement or final award.
(3) In the case that death results from the injury:
(A) death benefits in a lump sum amount of one hundred seventy-five thousand dollars ($175,000), payable upon agreement or final award to any dependents of the student under sections 11 through 14 of this chapter, or, if the student has no dependents, to the student’s parents; and
(B) burial compensation under section 15 of this chapter.
(c) For the sole purpose of modifying an award under section 27 of this chapter, a school to work student’s average weekly wage is presumed to be equal to the federal minimum wage.
(d) A school to work student is not entitled to the following compensation under this chapter:
(1) Temporary total disability compensation under section 16 of this chapter.
(2) Temporary partial disability compensation under section 19 of this chapter.
(e) Except for remedies available under IC 5-2-6.1, recovery under subsection (b) is the exclusive right and remedy for:
(1) a school to work student; and
(2) the personal representatives, dependents, or next of kin, at common law or otherwise, of a school to work student;
on account of disablement or death by occupational disease arising out of and in the course of school to work employment.
As added by P.L.235-1999, SEC.6.