Indiana Code
Article 8. Life, Accident, and Health
Chapter 16. Medical Claims Review

27-8-16-0.5. Applicability of Chapter - Sec. 0.5. (a) This chapter applies to the following: (1)...

27-8-16-1. "Claim Review Agent" Defined - Sec. 1. (a) As used in this chapter, "claim review...

27-8-16-1.5. "Claim Review Consultant" Defined - Sec. 1.5. (a) As used in this chapter, "claim review...

27-8-16-2. "Department" Defined - Sec. 2. As used in this chapter, "department" refers to...

27-8-16-3. "Enrollee" Defined - Sec. 3. As used in this chapter, "enrollee" means an...

27-8-16-4. "Medical Claims Review" Defined - Sec. 4. (a) As used in this chapter, "medical claims...

27-8-16-4.5. "Person" Defined - Sec. 4.5. As used in this chapter, "person" means an...

27-8-16-5. Certificate of Registration; Issuance to Agent - Sec. 5. (a) A claim review agent may not conduct...

27-8-16-5.2. Certificate of Registration; Application; Requirements; Application Fee - Sec. 5.2. (a) A person may not act as a...

27-8-16-6. Certificate of Registration; Renewal; Transfer; Notice of Change in Information - Sec. 6. (a) To remain in effect, a certificate of...

27-8-16-7. Minimum Claim Review Agent Requirements - Sec. 7. A claim review agent must satisfy the following...

27-8-16-8. Appeals Procedure; Written Description; Minimum Standards; Notice of Appeal Procedure on Limitation or Reduction of Benefits - Sec. 8. (a) An insurance company, a health maintenance organization,...

27-8-16-9. Provider's Statement; Documentation of Review Agent Capability - Sec. 9. To provide documentation demonstrating that a claim review...

27-8-16-9.5. Claim Determinations Based on Data Base Information - Sec. 9.5. (a) As used in this section, "data base"...

27-8-16-10. Fraudulent or Misleading Information; Penalties - Sec. 10. A provider, an enrollee, or an agent of...

27-8-16-11. Prohibited Bases for Compensation of Claim Review Agents and Consultants - Sec. 11. (a) The compensation of a claim review agent...

27-8-16-12. Violations; Claims Review Agent; Notice; Cease and Desist Orders; Penalties; Revocation or Suspension of Registration; Review - Sec. 12. (a) If the department believes that a claim...

27-8-16-13. Confidential Information - Sec. 13. (a) This chapter does not require a claim...

27-8-16-14. Rules - Sec. 14. The department shall adopt rules under IC 4-22-2...