Sec. 1.6. (a) This section does not apply to claims submitted for payment by nursing facilities.

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Terms Used In Indiana Code 12-15-13-1.6

  • clean claim: means a claim submitted by a provider for payment under the Medicaid program that can be processed without obtaining additional information from:

    Indiana Code 12-15-13-0.5

  • office: includes the following:

    Indiana Code 12-15-13-0.4

     (b) The office shall pay or deny each clean claim in accordance with section 1.7 of this chapter.

     (c) The office shall deny or suspend each claim that is not a clean claim in accordance with subsection (d).

     (d) The office shall deny or suspend each claim that is:

(1) not a clean claim; and

(2) submitted by a provider for payment under the Medicaid program;

not more than thirty (30) days after the date the claim is received by the office or, if IC 12-15-30 applies, by the contractor under IC 12-15-30.

     (e) If the office denies a provider’s claim for payment under subsection (d) or section 1.7 of this chapter, the office shall notify the provider of each reason the claim was denied.

     (f) If the office suspends a provider’s claim for payment under subsection (d), the office shall notify the provider of each reason the claim was suspended.

As added by P.L.107-1996, SEC.7 and P.L.257-1996, SEC.7.