Indiana Code 5-10-8.1-7. Payment or denial of claims; interest
(1) If the claim is filed electronically, not more than thirty (30) days after the date the claim is received by the administrator.
Terms Used In Indiana Code 5-10-8.1-7
- administrator: means :
Indiana Code 5-10-8.1-1
- clean claim: means a claim submitted by a provider for payment under a health benefit plan that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment. See Indiana Code 5-10-8.1-2
- health benefit plan: means a self-insurance program established to provide group health coverage as described in IC 5-10-8-7(b), or a contract for health services as described in IC 5-10-8-7(c). See Indiana Code 5-10-8.1-4
- Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
- provider: has the meaning set forth in IC 27-8-11-1. See Indiana Code 5-10-8.1-5
(b) If:
(1) the administrator fails to pay or deny a clean claim in the time required under subsection (a); and
(2) the administrator subsequently pays the claim;
the administrator shall pay the provider that submitted the claim interest on the health benefit plan allowable amount of the claim paid under this section.
(c) Interest paid under subsection (b):
(1) accrues beginning:
(A) thirty-one (31) days after the date the claim is filed under subsection (a)(1); or
(B) forty-six (46) days after the date the claim is filed under subsection (a)(2); and
(2) stops accruing on the date the claim is paid.
(d) In paying interest under subsection (b), the administrator shall use the same interest rate as provided in IC 12-15-21-3(7)(A).
As added by P.L.162-2001, SEC.1.