Section 405IAC10-9-2. Provider grievances and appeals; insurers

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   (a) The right of providers contracting with insurers to dispute any actions taken by the insurer shall be governed by the provider's contract with the insurer.

  (b) The reimbursement dispute resolution procedure set forth at 405 IAC 1-1.6 shall apply to providers who do not have a contract with an insurer for services provided under the plan.

  (c) Any provider disputes involving prior authorization determinations made by the insurers shall be governed by the insurers' procedures for provider grievances and appeals.

  (d) A contracted or noncontracted provider shall have no right to appeal an insurer's action to the state. (Office of the Secretary of Family and Social Services; 405 IAC 10-9-2; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)

                    
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