Sec. 7. Each health maintenance organization shall provide the following:
(1) Telephone access to the health maintenance organization during business hours to ensure enrollee access for routine care.
(2) Twenty-four (24) hour telephone access to either:
(A) a representative of the health maintenance organization; or
(B) a participating provider;
for authorization for care.
As added by P.L.69-1998, SEC.14.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 36. Patient Protection; Clinical Decision Making; Access to Personnel and Facilities
27-13-36-2. Sufficient Number and Type of Primary Care Providers
27-13-36-2.5. Discrimination on Basis of Provider's License or Certification Prohibited
27-13-36-3. Adequate Number of Services and Providers Within Reasonable Proximity of Subscribers
27-13-36-4. Specialty Areas of Primary Care Providers
27-13-36-5. Referrals to Out of Network Providers
27-13-36-6. Continuation of Care Provisions
27-13-36-7. Telephone Access for Authorization of Care
27-13-36-8. Guidelines for Establishing Reasonable Periods for Appointments
27-13-36-9. Coverage and Reimbursement for Expenses for Care Obtained in an Emergency
27-13-36-11. Standards for Continuity of Care
27-13-36-12. Payment to Enrollee for Service Rendered by Nonparticipating Provider; Requirements