Ind. Code § 27-13-36.2-5

Current through P.L. 171-2024

Section 27-13-36.2-5 - Permitted forms

A provider shall submit only the following forms for payment by a health maintenance organization:

(1) CMS-1500.

(2) CMS-1450 (UB-04).

(3) American Dental Association (ADA) claim form.

IC 27-13-36.2-5

Amended by P.L. 208-2018,SEC. 32, eff. 7/1/2018.

As added by P.L. 162-2001, SEC.6.