Notice requirement
Ind. Code § 27-1-52-11
in effectSec. 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.
As added by P.L.88-2026, SEC.6.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026