§ 27-13-36.2-1 “Clean claim” defined
§ 27-13-36.2-2 “Health maintenance organization” defined
§ 27-13-36.2-3 Notice of deficiencies in claims
§ 27-13-36.2-4 Payment or denial of claims; interest
§ 27-13-36.2-4.5 Prohibition on altering CPT code for claim; exceptions
§ 27-13-36.2-5 Permitted forms
§ 27-13-36.2-6 Civil penalties
§ 27-13-36.2-8 Claim payment errors
§ 27-13-36.2-9 Claim overpayment adjustment

Terms Used In Indiana Code > Title 27 > Article 13 > Chapter 36.2 - Provider Payment

  • clean claim: means a claim submitted by a provider for payment for health care services provided to an enrollee that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment. See Indiana Code 27-13-36.2-1
  • Contract: A legal written agreement that becomes binding when signed.
  • Fraud: Intentional deception resulting in injury to another.
  • health maintenance organization: includes :

    Indiana Code 27-13-36.2-2

  • Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
  • medical record: means written or printed information possessed by a provider (as defined in Ind. See Indiana Code 1-1-4-5
  • Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5