Indiana § 27-8-16-4 - "Medical claims review" defined
Full text of Indiana Indiana Code § 27-8-16-4 — "Medical claims review" defined, with citation guidance and answers to common questions.
§ 27-8-16-4. "Medical claims review" defined
Sec. 4. (a) As used in this chapter, "medical claims review" means the determination of the reimbursement to be provided under the terms of an insurance policy, a health maintenance organization contract, or another benefit program providing payment, reimbursement, or indemnification for health care costs based on the appropriateness of health care services or the amount charged for a health care service delivered to an enrollee.
(b) The term does not include the prospective, concurrent, or retrospective utilization review of health care services.
(c) The term does not include the identification of alternative, optional medical care that:
(1) requires the approval of the enrollee or covered individual; and
(2) does not affect coverage or benefits if rejected by the enrollee or covered individual.
As added by P.L.128-1992, SEC.2. Amended by P.L.135-1994, SEC.1.
Source: official Indiana text · Last verified 2026-08-27
Frequently Asked Questions About Indiana § 27-8-16-4
What does Indiana Code § 27-8-16-4 cover?
Section 27-8-16-4 (""Medical claims review" defined") 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 § 27-8-16-4?
A common citation format is "Indiana Code § 27-8-16-4" (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 § 27-8-16-4 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.