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) forty-five (45) days for a claim that is filed on paper;
and describe any remedy necessary to establish a clean claim.
(c) Failure of an administrator to notify a provider as required under subsection (b) establishes the submitted claim as a clean claim.
As added by P.L.162-2001, SEC.1. Amended by P.L.137-2002, SEC.1.
Structure Indiana Code
Title 5. State and Local Administration
Article 10. Public Employee Benefits
Chapter 8.1. State Employee Health Benefits; Provider Payment
5-10-8.1-1. "Administrator" Defined
5-10-8.1-2. "Clean Claim" Defined
5-10-8.1-3. "Covered Individual" Defined
5-10-8.1-4. "Health Benefit Plan" Defined
5-10-8.1-5. "Provider" Defined
5-10-8.1-6. Notice of Deficiencies in Claims