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IC 27-1-37.5 – Health Care Service Prior Authorization | Midpage
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Indiana Code
Title 27
1
Chapter 37.5
IC 27-1-37.5
Health Care Service Prior Authorization
1
Application of chapter
1.5
"Adverse determination"
1.6
"Authorization"
1.7
"Clinical peer"
1.8
"Clinical criteria"
1.9
"Cosmetic surgery"
2
"Covered individual"
3
"CPT code"
3.7
"Emergency health care service"
3.8
"Episode of care"
3.9
"Health care provider"
4
"Health care service"
5
"Health plan"
5.4
"Medically necessary"
6
"Participating provider"
7
"Prior authorization"
8
Repealed
8.1
"Urgent health care service"
8.3
"Utilization review entity"
9
Repealed
10
Request for prior authorization; electronic transmission or application programming interface; standardized form
11
Repealed
12
Claim for which prior authorization was given; denial; resubmission of claim
13
Unanticipated, medically necessary health care service
13.5
Expired
13.7
Limitations on prior authorization requirements for physical therapy or chiropractic visits
14
Contrary contract provision void
15
Violation of chapter
16
Department of insurance; standardized prior authorization form
17
Peer to peer review; request
19
Publishing prior authorization requirements and restrictions and information about prior authorization approvals and denials; implementing new or amending current prior authorization requirements o
20
Use of clinical peer when an adverse determination is made or when reviewing or deciding an appeal
21
Clinical peer's duty to a covered individual
23
Request for prior authorization; process
24
Emergency admission or provision of emergency health care services
25
Limitation on a utilization review entity's authority to revoke, limit, condition, or restrict an authorization
26
Authorization periods
27
Utilization review entity's duty to honor certain authorizations
28
Automatic authorization for failure to comply with deadlines or requirements