Part Definitions

1. Law
2. Tennessee Code
3. Insurance
4. Policies and Policyholders
5. Tennessee Right to Shop Act
6. Part Definitions

As used in this part:

1. “Allowed amount” means the contractually agreed upon payment amount between a carrier and a healthcare entity participating in the carrier's network, excluding any member deductible, co-pay, or other obligation;
2. “Commissioner” means the commissioner of commerce and insurance;
3. “Comparable healthcare service” includes, but is not limited to:
   1. Physical and occupational therapy services;
   2. Radiology and imaging services;
   3. Laboratory services; and
   4. Infusion therapy;
4. “Department” means the department of commerce and insurance;
5. “Health plan” means health insurance coverage as defined in § 56-7-109;
6. “Healthcare entity” means:
   1. Any healthcare facility licensed under title 33 or 68; and
   2. Any healthcare provider licensed under title 63 or 68;
7. “Insurance carrier” or “carrier” means a health insurance entity as defined in § 56-7-109; and
8. “Shopping and decision support program” means the program established by a carrier pursuant to this part.

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