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§ 27-8-16-9-5 — Indiana Law | CourtGPT
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  6. Chapter 16 - Medical Claims Review27-8-16-0.5. Applicability of Chapter/
  7. § 27-8-16-9-5
Indiana Legal Code

§ 27-8-16-9-5

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(b) If a claim review agent bases a medical claims review determination concerning a health care service provided by a hospital licensed under IC 12-25 or IC 16-21 in whole or in part on information obtained from a data base, the information must relate exclusively to services provided by a hospital licensed under IC 12-25 or IC 16-21.(c) If a claim review consultant makes a recommendation or provides consultation concerning the appropriateness of or the amount charged for services provided by a hospital licensed under IC 12-25 or IC 16-21 based in whole or in part on information obtained from a data base, the information must relate exclusively to services provided by a hospital licensed under IC 12-25 or IC 16-21.(d) This section does not apply to:(1) medical claims review determinations made under subsection (b); or(2) consultations or recommendations made under subsection (c);regarding medical services provided under IC 22.As added by P.L.260-1995, SEC.7.