Learn About The Law
Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 13. (a) A fully credentialed provider shall be reimbursed for eligible services provided at any in-network hospital if the following conditions are met:
(1) The provider submits the documentation required by the insurer to be loaded under the provider group or hospital.
(2) The provider, provider group, or hospital is a network provider with the insurer.
(3) The services are provided in accordance with all terms and conditions of the provider's, group provider's, or hospital's agreement or contract with the insurer.
(4) Prior authorization is obtained in accordance with IC 27-1-37.5 when required by the insurer for an eligible service.
(b) The insurer shall reimburse the provider or hospital for services described in subsection (a) at the rates determined by the contract between the provider and the insurer.
(c) An insurer is not required to credential a provider. However, if:
(1) a provider is employed by a hospital that is part of the hospital's network that is covered by the insurer; and
(2) the provider meets the insurer's credentialing requirements;
the insurer shall reimburse the provider for any reimbursable services from the date that the provider was employed by the hospital.
Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-8-11-13 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-8-11-13/
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.
A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.
Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
Search our directory by legal issue
Enter information in one or both fields (Required)