Section 12-15-13-1 - Payment, denial, or suspension of claims submitted by nursing facilities; time; notice of suspension or denial(a) This section applies only to claims submitted for payment by nursing facilities.(b) The office shall pay, deny, or suspend each claim submitted by a provider for payment under the Medicaid program not more than:(1) twenty-one (21) days after the date a claim that is filed electronically; or(2) thirty (30) days after the date a claim that is filed on paper; is received by the office or, if IC 12-15-30 applies, by the contractor under IC 12-15-30.
(c) The office shall pay each clean claim.(d) The office may deny or suspend a claim that is not a clean claim. If the office denies a provider's claim for payment, the office shall notify the provider of each reason the claim was denied.(e) If the office suspends a provider's claim for payment under the Medicaid program, the office shall notify the provider of each reason the claim was suspended.Pre-1992 Revision Citation: 12-1-7-16.5.
As added by P.L. 2-1992, SEC.9. Amended by P.L. 10-1994, SEC.4; P.L. 107-1996, SEC.5; P.L. 257-1996, SEC.5.