Chapter 16 - MEDICAL CLAIMS REVIEW
- Section 27-8-16-0.5 - Applicability of chapter
- Section 27-8-16-1 - "Claim review agent" defined
- Section 27-8-16-1.5 - "Claim review consultant" defined
- Section 27-8-16-2 - "Department" defined
- Section 27-8-16-3 - "Enrollee" defined
- Section 27-8-16-4 - "Medical claims review" defined
- Section 27-8-16-4.5 - "Person" defined
- Section 27-8-16-5 - Certificate of registration; issuance to agent
- Section 27-8-16-5.2 - Certificate of registration; application; requirements; application fee
- Section 27-8-16-6 - Certificate of registration; renewal; transfer; notice of change in information
- Section 27-8-16-7 - Minimum claim review agent requirements
- Section 27-8-16-8 - Appeals procedure; written description; minimum standards; notice of appeal procedure on limitation or reduction of benefits
- Section 27-8-16-9 - Provider's statement; documentation of review agent capability
- Section 27-8-16-9.5 - Claim determinations based on data base information
- Section 27-8-16-10 - Fraudulent or misleading information; penalties
- Section 27-8-16-11 - Prohibited bases for compensation of claim review agents and consultants
- Section 27-8-16-12 - Violations; claims review agent; notice; cease and desist orders; penalties; revocation or suspension of registration; review
- Section 27-8-16-13 - Confidential information
- Section 27-8-16-14 - Rules