Indiana Code 27-13-34-26. Complaints; records
(b) The department shall classify complaints described in subsection (a) in categories according to the NAIC standardized complaint report procedures or standardized complaint report procedures established by the department in rules adopted under IC 4-22-2.
Terms Used In Indiana Code 27-13-34-26
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Contract: A legal written agreement that becomes binding when signed.
- enrollee: means an individual who is entitled to limited health services under a contract with an entity authorized to provide or arrange for limited health services under this chapter. See Indiana Code 27-13-34-1
- limited service health maintenance organization: means a corporation, partnership, limited liability company, or other entity that undertakes to provide or arrange a limited health service on a prepayment basis or other basis. See Indiana Code 27-13-34-4
- provider: means a physician, a dentist, an optometrist, a health facility, or other person or institution that is licensed or otherwise authorized to deliver or furnish limited health service. See Indiana Code 27-13-34-5
(1) number of complaints for which corrective action is considered necessary by the department; and
(2) number of complaints classified by NAIC disposition codes or standardized disposition codes established by the department in rules adopted under IC 4-22-2.
(d) The department shall make information specified in this section available to the public in a form that does not identify any specific individual.
(e) A limited service health maintenance organization that provides dental care services may not take any retaliatory action, including cancellation or refusal to renew a participating provider contract, individual contract, or group contract, solely because a participating provider, enrollee, or individual or group contract holder files a complaint against the limited service health maintenance organization.
As added by P.L.91-2000, SEC.2. Amended by P.L.124-2018, SEC.97.