Indiana § 27-8-11-13 - Fully credentialed provider reimbursement; requirements
Full text of Indiana Indiana Code § 27-8-11-13 — Fully credentialed provider reimbursement; requirements, with citation guidance and answers to common questions.
§ 27-8-11-13. Fully credentialed provider reimbursement; requirements
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.
As added by P.L.50-2020, SEC.8.
Source: official Indiana text · Last verified 2026-08-27
Frequently Asked Questions About Indiana § 27-8-11-13
What does Indiana Code § 27-8-11-13 cover?
Section 27-8-11-13 ("Fully credentialed provider reimbursement; requirements") is part of the Indiana Code, the codified statutory law of Indiana. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Indiana § 27-8-11-13?
A common citation format is "Indiana Code § 27-8-11-13" (Indiana). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Indiana law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Indiana official source linked on this page or consult a licensed Indiana attorney.
How does Indiana § 27-8-11-13 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Indiana can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Indiana.