Sec. 7. A provider shall submit only the following forms for payment by an insurer:
(1) CMS-1500.
(2) CMS-1450 (UB-04).
(3) American Dental Association (ADA) claim form.
As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 5.7. Accident and Sickness Insurance; Provider Payment
27-8-5.7-1. "Accident and Sickness Insurance Policy" Defined
27-8-5.7-2. "Clean Claim" 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