"Individual provider form"

Ind. Code § 16-51-1-5, under Chapter 1. Health Care Billing.

Ind. Code § 16-51-1-5

Sec. 5. (a) As used in this chapter, "individual provider form" means a medical claim form that: (1) is accepted by the federal Centers for Medicare and Medicaid Services for use by individual providers or groups of providers; and (2) includes a claim field for disclosure of the site at which the health care services to which the form relates were provided. (b) The term includes the following: (1) The CMS-1500 form or its successor form. (2) The HCFA-1500 form or its successor form. (3) The HIPAA X12 837P electronic claims transaction for professional services, or its successor transaction. As added by P.L.203-2023, SEC.18.