Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 9 - Providers
Section 9-4 - Provider reimbursement; managed care organizations
Universal Citation: 405 IN Admin Code 9-4
Current through September 18, 2024
Authority: IC 12-15-44.5-9
Affected: IC 12-15-44.5-5
Sec. 4.
(a) Reimbursement matters including:
(1) the time
limit for filing claims; and
(2)
rates paid to providers contracting with managed care organizations;
shall be governed by the contract between the provider and the managed care organization.
(b) Reimbursement rates paid by managed care organizations to providers without contracts who render services to plan members shall be at plan reimbursement rates governed by IC 12-15-44.5-5.
(c) No provider retains any independent or duplicative right for reimbursement from the office in addition to or in lieu of reimbursement received from the managed care organization.
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