Ind. Code § 27-8-5.7-7
Permitted forms
As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.
A provider shall submit only the following forms for payment by an insurer:
- (1) CMS-1500.
- (2) CMS-1450 (UB-04).
- (3) American Dental Association (ADA) claim form.
As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.