Indiana Administrative Code
Title 470 - DIVISION OF FAMILY RESOURCES
Article 11.1 - HOSPITAL CARE FOR THE INDIGENT
Rule 4 - Hospital Care for the Indigent Payment Procedures
Section 4-3 - Payment denials; recovery of overpayments

Universal Citation: 470 IN Admin Code 4-3

Current through September 18, 2024

Authority: IC 12-13-2-3; IC 12-13-5-3

Affected: IC 12-16

Sec. 3.

(a) The division shall deny the payment of any claim or seek the recovery of any improper payment on any claim when the provider or the patient has failed to comply with the requirements of IC 12-5-6[IC 12-5 was repealed by P.L. 2-1992, SECTION 897, effective February 14, 1992.], et seq. or any of the rules promulgated thereunder.

(b) The division shall also deny the payment of any claim or seek the recovery of any improper payment on any claim where it is shown that either the provider or the patient has failed to comply with 405 IAC 1-1-4 or 405 IAC 1-1-5.

(c) The division shall also deny payments if the allocated funds for the hospital care for the indigent program are insufficient to meet the otherwise allowed rate as defined in section 2(b) of this rule.

(d) In the event that the division denies a provider's claim, said claim will be returned to the provider within a reasonable period after receipt thereof with an explanation of the reasons for its denial.

Disclaimer: These regulations may not be the most recent version. Indiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.