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Indiana Code 27-13-36.2-5. Permitted forms

   Sec. 5. A provider shall submit only the following forms for payment by a health maintenance organization:

(1) CMS-1500.

Terms Used In Indiana Code 27-13-36.2-5

  • health maintenance organization: includes :

    Indiana Code 27-13-36.2-2

(2) CMS-1450 (UB-04).

(3) American Dental Association (ADA) claim form.

As added by P.L.162-2001, SEC.6. Amended by P.L.208-2018, SEC.32.

Indiana Code 27-13-36-2.5. Discrimination on basis of provider’s license or certification prohibited

   Sec. 2.5. (a) A health maintenance organization may not discriminate against a provider acting within the scope of the provider’s license or certification with respect to:

(1) participation;

Terms Used In Indiana Code 27-13-36-2.5

  • Contract: A legal written agreement that becomes binding when signed.
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
(2) reimbursement;

(3) indemnification; or

(4) scope of care;

solely on the basis of the provider’s license or certification.

     (b) This section does not require a health maintenance organization to enter into a contract with a provider that would allow the provider to enter the health maintenance organization network.

As added by P.L.233-1999, SEC.13.