Ind. Code § 27-13-36.2-9.5

Error in coordination of benefits; submission of claim to appropriate health maintenance organization

As added by P.L.88-2026, SEC.16.
  1. (a) If an insurer (as defined in IC 27-8-5.7-3 ) or a health maintenance organization recoups payment from a provider due to an error in coordination of benefits, the provider may submit a claim for the same services to the appropriate health maintenance organization.
  2. (b) Except as provided in subsection (d) and notwithstanding any other provision of law, a provider may submit a claim to the appropriate health maintenance organization not later than ninety (90) days after the date the recoupment is made.
  3. (c) A provider that submits a claim under this section shall provide documentation to the health maintenance organization demonstrating:

    1. (1) the original submission of the claim to the initial insurer or health maintenance organization; and
    2. (2) the recoupment of payment by the initial insurer or health maintenance organization due to an error in coordination of benefits.
  4. (d) Nothing in this section prevents a health maintenance organization from allowing a provider more time to submit a claim.

As added by P.L.88-2026, SEC.16.

Log InSign Up