Binding Nature of External Review Decisions

1. Law
2. Tennessee Code
3. Insurance
4. Tennessee Health Carrier Grievance and External Review Procedure Act
5. Binding Nature of External Review Decisions

1. An external review decision is binding on the health carrier except to the extent that the health carrier has other remedies available under applicable federal or state law.
2. An external review decision is binding on the covered person except to the extent that the covered person has other remedies available under applicable federal or state law.
3. An external review decision is binding on the healthcare provider except to the extent that the healthcare provider has other remedies available under applicable federal or state law.
4. An aggrieved person may not file a subsequent request for external review involving the same adverse determination or final adverse determination for which the covered person has already received an external review decision pursuant to this chapter.

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