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Tennessee Health Carrier Grievance and External Review Procedure Act
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Tennessee Code
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Tennessee Health Carrier Grievance and External Review Procedure Act
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Section
56-61-101
Short Title — Purpose
Section
56-61-102
Chapter Definitions
Section
56-61-103
Applicability and Scope
Section
56-61-104
No Limitations or Restrictions on Denying Coverage of Services Not Medically Necessary
Section
56-61-105
Maintenance of Register of Written Records to Document Grievances
Section
56-61-106
Written Procedures for Grievances
Section
56-61-107
First Level Review of Adverse Determination
Section
56-61-108
Second Level Review of Adverse Determination
Section
56-61-109
Establishment of Written Procedures for Expedited Review of Urgent Care Requests of Grievances Involving Adverse Determination
Section
56-61-110
Rules and Regulations
Section
56-61-111
Penalties for Violations
Section
56-61-112
Elections for Conducting External Review Program
Section
56-61-113
Notice of Right to External Review
Section
56-61-114
Request for External Review
Section
56-61-115
Exhaustion of Internal Grievance Process
Section
56-61-116
Standard External Review
Section
56-61-117
Expedited External Review
Section
56-61-118
Requests for External Review When Service or Treatment Determined to Be Investigational
Section
56-61-119
Binding Nature of External Review Decisions
Section
56-61-120
Approval of External Review Organizations
Section
56-61-121
Minimum Qualifications for Independent Review Organizations
Section
56-61-122
Hold Harmless for External Review Organizations
Section
56-61-123
External Review Reporting Requirements
Section
56-61-124
Funding of External Review
Section
56-61-125
Disclosure Requirements