Indiana Code 5-10-8.1-6. Notice of deficiencies in claims
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Sec. 6. (a) The administrator shall pay or deny each clean claim in accordance with section 7 of this chapter.
(1) thirty (30) days for a claim that is filed electronically; or
(b) An administrator shall notify a provider of any deficiencies in a submitted claim not more than:
Terms Used In Indiana Code 5-10-8.1-6
- administrator: means :
Indiana Code 5-10-8.1-1
- clean claim: means a claim submitted by a provider for payment under a health benefit plan that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment. See Indiana Code 5-10-8.1-2
- provider: has the meaning set forth in IC 27-8-11-1. See Indiana Code 5-10-8.1-5
(2) forty-five (45) days for a claim that is filed on paper;
and describe any remedy necessary to establish a clean claim.
(c) Failure of an administrator to notify a provider as required under subsection (b) establishes the submitted claim as a clean claim.
As added by P.L.162-2001, SEC.1. Amended by P.L.137-2002, SEC.1.