Sec. 6. A claim for reimbursement for services shall be treated as a disputed claim under this chapter if:
(1) it is submitted within one hundred twenty (120) days after the date that services are rendered;
(2) it is denied by the managed care organization;
(3) the hospital submits a written notice of dispute for the claim to the managed care organization not more than sixty (60) days after the receipt of the denial notice;
(4) it is appealed in accordance with the managed care organization's internal appeals process; and
(5) payment for the claim is denied by the managed care organization following its internal appeals process.
As added by P.L.142-2000, SEC.2. Amended by P.L.152-2017, SEC.9.
Structure Indiana Code
Chapter 11.5. Lake County Disproportionate Share Hospitals
12-15-11.5-0.5. Nonapplicability to Certain Managed Care Organizations
12-15-11.5-2. Hospital as Contracted Provider to Eligible Individuals
12-15-11.5-6. Claim for Reimbursement Treated as Disputed Claim
12-15-11.5-7. Conclusion of Appeal