Ind. Code § 27-1-52-11
Notice requirement
Indiana · Indiana Code Title 27 — Insurance · Status: effective
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- Citation
- Ind. Code § 27-1-52-11, Notice requirement, Indiana, version 1 as recorded 2026-09-28, yourstate.us, https://yourstate.us/provision/1662838
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Full text
Sec. 11. If a claim is downcoded, the insurer shall:
(1) notify the provider using the appropriate CARC and RARC to clearly indicate that the claim has been downcoded; and
(2) provide:
(A) the specific reason for the downcoding, including reference to the clinical criteria used to justify the downcoding;
(B) the original and revised service codes and payment amounts; and
(C) a notice of the right to appeal as described in section 12 of this chapter.