§ 56-7-3301. Part Definitions
As used in this part, unless the context otherwise requires: “Health care provider” or “provider” means any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11, with whom the health insurance entity has an express and valid network provider agreement or contract; “Health insurance entity” has the same meaning […]
§ 56-7-3302. Clear Identification of Material Changes to Provider Manual
A health insurance entity shall provide notice to a healthcare provider of any material change made in the sole discretion of the insurance entity to the entity’s previously released provider manual or a reimbursement rule and policy at least sixty (60) days prior to the effective date of the change, and the health insurance entity […]
§ 56-7-3303. Establishment and Maintenance of Internet Web Site — Web-Based Preadjudication Tool
By July 1, 2010, a health insurance entity shall establish and maintain an Internet web site, which shall be accessible to health care providers with whom the health insurance entity has an express and a valid network provider agreement or contract. Excluding inpatient claims, every health insurance entity shall make available on the Internet web […]
§ 56-7-3304. Applicability of Part
This part shall not apply to a contract between a health care provider and the state or federal government or their agencies for health care services provided through a program for medicare; the state group insurance program; TennCare or any successor program provided for in title 71, chapter 5; the CoverKids Act of 2006 provided […]