§ 27-8-5.7-1 “Accident and sickness insurance policy” defined
§ 27-8-5.7-2 “Clean claim” defined
§ 27-8-5.7-2.5 “CPT code”
§ 27-8-5.7-3 “Insurer” defined
§ 27-8-5.7-4 “Provider” defined
§ 27-8-5.7-5 Notice of deficiencies in claims
§ 27-8-5.7-6 Payment or denial of claims; interest
§ 27-8-5.7-6.5 Prohibition on altering CPT code for claim; exceptions
§ 27-8-5.7-7 Permitted forms
§ 27-8-5.7-8 Civil penalties
§ 27-8-5.7-10 Claim payment errors
§ 27-8-5.7-11 Claim overpayment adjustment

Terms Used In Indiana Code > Title 27 > Article 8 > Chapter 5.7 - Accident and Sickness Insurance; Provider Payment

  • accident and sickness insurance policy: has the meaning set forth in IC 27-8-5-1. See Indiana Code 27-8-5.7-1
  • clean claim: means a claim submitted by a provider for payment under an accident and sickness insurance policy issued in Indiana that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment. See Indiana Code 27-8-5.7-2
  • Contract: A legal written agreement that becomes binding when signed.
  • CPT code: refers to the medical billing code that applies to a specific health care service, as published in the Current Procedural Terminology code set maintained by the American Medical Association. See Indiana Code 27-8-5.7-2.5
  • Fraud: Intentional deception resulting in injury to another.
  • insurer: means an insurance company issued a certificate of authority in Indiana to issue accident and sickness insurance policies. See Indiana Code 27-8-5.7-3
  • 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
  • provider: has the meaning set forth in IC 27-8-11-1. See Indiana Code 27-8-5.7-4
  • Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5