Sec. 14. (a) A good faith estimate provided by a provider facility to an individual under this chapter must:

(1) provide a summary of the services and material items that the good faith estimate is based on; and

Terms Used In Indiana Code 27-1-46-14

  • good faith estimate: means a reasonable estimate of the price each provider anticipates charging for an episode of care for nonemergency health care services that:

    Indiana Code 27-1-46-2

  • health carrier: means an entity:

    Indiana Code 27-1-46-3

  • practitioner: means :

    Indiana Code 27-1-46-8

  • provider: means :

    Indiana Code 27-1-46-9

  • provider facility: means any of the following:

    Indiana Code 27-1-46-10

(2) include a total figure that is a sum of the estimated prices referred to in subdivision (1).

     (b) Subsection (a) does not prohibit a provider facility from providing to an individual a good faith estimate that indicates how much of the total figure stated under subsection (a)(2) will be the individual’s out-of-pocket expense after the health carrier‘s payment of charges.

     (c) A health carrier or practitioner must provide a provider facility with the information needed by the provider facility to comply with the requirements under this chapter not more than two (2) business days after receiving the request.

     (d) A provider facility is not subject to the penalties under section 17 of this chapter if:

(1) a health carrier or practitioner fails to provide the provider facility with the information as required under subsection (c);

(2) the provider facility provides the individual with a good faith estimate based on any information that the provider facility has; and

(3) the provider facility provides the individual with an updated good faith estimate after the health carrier or practitioner has provided the information required under subsection (c).

As added by P.L.93-2020, SEC.12.

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