Section 27-13-36.2-3 - Notice of deficiencies in claims(a) A health maintenance organization shall pay or deny each clean claim in accordance with section 4 of this chapter.(b) A health maintenance organization shall notify a provider of any deficiencies in a submitted claim not more than: (1) thirty (30) days for a claim that is filed electronically; or(2) forty-five (45) days for a claim that is filed on paper; and describe any remedy necessary to establish a clean claim.
(c) Failure of a health maintenance organization to notify a provider as required under subsection (b) establishes the submitted claim as a clean claim.As added by P.L. 162-2001, SEC.6. Amended by P.L. 137-2002, SEC.3.