Ind. Code § 5-10-8.1-8
Permitted forms
As added by P.L.162-2001, SEC.1. Amended by P.L.208-2018, SEC.1.
A provider shall submit only the following forms for payment by an administrator:
- (1) CMS-1500.
- (2) CMS-1450 (UB-04).
- (3) American Dental Association (ADA) claim form.
As added by P.L.162-2001, SEC.1. Amended by P.L.208-2018, SEC.1.