Ind. Code § 27-8-11-13
Fully credentialed provider reimbursement; requirements
Indiana · Indiana Code Title 27 — Insurance · Status: effective
Cite this
- Citation
- Ind. Code § 27-8-11-13, Fully credentialed provider reimbursement; requirements, Indiana, version 1 as recorded 2026-09-28, yourstate.us, https://yourstate.us/provision/1663989
- Permanent ID
ys:prov:1663989@1- SHA-256
52f8f62db9d0f1df40bf669613750292225ee9b0d1dad51929011c62b1ca7d81
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
Sec. 13.
(a) A fully credentialed provider shall be reimbursed for eligible services provided at any in-network hospital if the following conditions are met:
(1) The provider submits the documentation required by the insurer to be loaded under the provider group or hospital.
(2) The provider, provider group, or hospital is a network provider with the insurer.
(3) The services are provided in accordance with all terms and conditions of the provider's, group provider's, or hospital's agreement or contract with the insurer.
(4) Prior authorization is obtained in accordance with IC 27-1-37.5 when required by the insurer for an eligible service.
(b) The insurer shall reimburse the provider or hospital for services described in subsection (a) at the rates determined by the contract between the provider and the insurer.
(c) An insurer is not required to credential a provider. However, if:
(1) a provider is employed by a hospital that is part of the hospital's network that is covered by the insurer; and
(2) the provider meets the insurer's credentialing requirements;
the insurer shall reimburse the provider for any reimbursable services from the date that the provider was employed by the hospital.