Sec. 4. (a) A health maintenance organization shall provide, at the request of the enrollee, subscriber, or legal representative of the enrollee or subscriber, and upon contract issuance, at each contract renewal, and with any notice of denial of a claim, timely, adequate, and appropriate notice to each enrollee, subscriber, or legal representative, of:

(1) the grievance procedure under this chapter and IC 27-13-10.1;

Terms Used In Indiana Code 27-13-10-4

  • Contract: A legal written agreement that becomes binding when signed.
(2) information on how to file:

(A) a grievance under this chapter; and

(B) a request for an external grievance review under IC 27-13-10.1; and

(3) the address for the Internet web site established by the department under IC 27-1-3-33.

     (b) A health maintenance organization shall prominently display on all notices to enrollees and subscribers the telephone number and address at which a grievance may be filed.

     (c) A written description of the enrollee’s or subscriber’s right to file a grievance must be posted by the provider in a conspicuous public location in each facility that offers services on behalf of a health maintenance organization.

As added by P.L.191-1997, SEC.6. Amended by P.L.133-1999, SEC.5; P.L.18-2016, SEC.5.