Chapter
Tennessee Health Carrier Grievance and External Review Procedure Act
- Tenn. Code Ann. § 56-61-101— Short title — Purpose
- Tenn. Code Ann. § 56-61-102— Chapter definitions
- Tenn. Code Ann. § 56-61-103— Applicability and scope
- Tenn. Code Ann. § 56-61-104— No limitations or restrictions on denying coverage of services not medically necessary
- Tenn. Code Ann. § 56-61-105— Maintenance of register of written records to document grievances
- Tenn. Code Ann. § 56-61-106— Written procedures for grievances
- Tenn. Code Ann. § 56-61-107— First level review of adverse determination
- Tenn. Code Ann. § 56-61-108— Second level review of adverse determination
- Tenn. Code Ann. § 56-61-109— Establishment of written procedures for expedited review of urgent care requests of grievances involving adverse determination
- Tenn. Code Ann. § 56-61-110— Rules and regulations
- Tenn. Code Ann. § 56-61-111— Penalties for violations
- Tenn. Code Ann. § 56-61-112— Elections for conducting external review program
- Tenn. Code Ann. § 56-61-113— Notice of right to external review
- Tenn. Code Ann. § 56-61-114— Request for external review
- Tenn. Code Ann. § 56-61-115— Exhaustion of internal grievance process
- Tenn. Code Ann. § 56-61-116— Standard external review
- Tenn. Code Ann. § 56-61-117— Expedited external review
- Tenn. Code Ann. § 56-61-118— Requests for external review when service or treatment determined to be investigational
- Tenn. Code Ann. § 56-61-119— Binding nature of external review decisions
- Tenn. Code Ann. § 56-61-120— Approval of external review organizations
- Tenn. Code Ann. § 56-61-121— Minimum qualifications for independent review organizations
- Tenn. Code Ann. § 56-61-122— Hold harmless for external review organizations
- Tenn. Code Ann. § 56-61-123— External review reporting requirements
- Tenn. Code Ann. § 56-61-124— Funding of external review
- Tenn. Code Ann. § 56-61-125— Disclosure requirements