Sec. 7. A medical service provider shall submit only the following forms for payment by a payor: (1) CMS 1450 (UB-04). (2) CMS 1500 (HCFA-1500). (3) American Dental Association (ADA) claim form. IC 22-3-8 Chapter 8. Representation Before Worker's Compensation Board 22-3-8-1 Attorneys; qualifications 22-3-8-2 Attorneys; registration; oath; records
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