Title 5, TITLE 5. STATE AND LOCAL ADMINISTRATION
355 chapters · 3,747 sections in this title.
Ind. Code § 5-10-8.1-1 "Administrator" defined
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Sec. 1. As used in this chapter, "administrator" means: (1) the state personnel department; (2) an entity with which the state contracts to administer health coverage under IC 5-10-8-7(b); or (3) a prepaid health care delivery plan with which the state contracts under IC 5-10-8-7…
Ind. Code § 5-10-8.1-2 "Clean claim" defined
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Sec. 2. As used in this chapter, "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. As added by P.L.162-2001, SEC.1.
Ind. Code § 5-10-8.1-3 "Covered individual" defined
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Sec. 3. As used in this chapter, "covered individual" means an individual who is: (1) covered under a self-insurance program established under IC 5-10-8-7(b) to provide group health coverage; or (2) entitled to services under a contract for health services entered into or renewed…
Ind. Code § 5-10-8.1-4 "Health benefit plan" defined
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Sec. 4. As used in this chapter, "health benefit plan" means a self-insurance program established to provide group health coverage as described in IC 5-10-8-7(b), or a contract for health services as described in IC 5-10-8-7(c). As added by P.L.162-2001, SEC.1.
Ind. Code § 5-10-8.1-5 "Provider" defined
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Sec. 5. As used in this chapter, "provider" has the meaning set forth in IC 27-8-11-1. As added by P.L.162-2001, SEC.1.
Ind. 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. (b) An administrator shall notify a provider of any deficiencies in a submitted claim not more than: (1) thirty (30) days for a claim that is filed electronically; or (2…
Ind. Code § 5-10-8.1-7 Payment or denial of claims; interest
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Sec. 7. (a) The administrator shall pay or deny each clean claim as follows: (1) If the claim is filed electronically, not more than thirty (30) days after the date the claim is received by the administrator. (2) If the claim is filed on paper, not more than forty-five (45) days …
Ind. Code § 5-10-8.1-8 Permitted forms
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Sec. 8. A provider shall submit only the following forms for payment by an administrator: (1) CMS-1500. (2) CMS-1450 (UB-04). (3) American Dental Association (ADA) claim form. As added by P.L.162-2001, SEC.1. Amended by P.L.208-2018, SEC.1.