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Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 7. (a) This section applies to claims submitted for payment under the program by a nursing facility participating in the program.
(b) The managed care organization shall pay, deny, or suspend each claim submitted by a nursing facility provider for payment under the program not later than:
(1) twenty-one (21) days after the claim was electronically filed; or
(2) thirty (30) days after a claim has been filed on paper;
from receipt by the managed care organization.
(c) If the managed care organization:
(1) fails to pay a clean claim in the time required under this section; or
(2) denies or suspends a claim that is subsequently determined to have been a clean claim when the claim was filed;
the managed care organization shall pay the provider interest on the Medicaid allowable amount of the claim as set forth in this section.
(d) Interest paid under subsection (c):
(1) accrues beginning:
(A) twenty-two (22) days from the date the claim is filed under subsection (b)(1); or
(B) thirty-one (31) days from the date the claim is filed under subsection (b)(2); and
(2) stops accruing on the date the managed care organization pays the claim.
(e) A managed care organization shall pay interest under subsection (c) to a provider at the rate established for Medicare overpayments and underpayments, as set forth in 42 CFR 405.378.
Cite this article: FindLaw.com - Indiana Code Title 12. Human Services § 12-15-12.7-7 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-15-12-7-7/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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