GroundRules
IC 5-10-8.1-8: Permitted forms
Where this section sits in the code
- TITLE 5. STATE AND LOCAL ADMINISTRATION
- ARTICLE 10. PUBLIC EMPLOYEE BENEFITS
- Chapter 8.1. State Employee Health Benefits; Provider Payment
Sec. 8. A provider shall submit only the following forms for payment by an administrator:
(1) CMS-1500.
(2) CMS-1450 (UB-04).
(3) American Dental Association (ADA) claim form.
Collected 2026-09-02T16:11:39Z. Source file · JSON