2019 Tennessee Code
Title 56 - Insurance
Chapter 61 - Tennessee Health Carrier Grievance and External Review Procedure Act
§ 56-61-125. Disclosure requirements.
(a) Each health carrier shall include a description of the external review procedures in or attached to the membership booklet, provider manual, and health carrier's web site. The health carrier may include a description of the external review procedures in the policy, certificate, outline of coverage, or other evidence of coverage provided to covered persons and providers.
(b) The disclosure required by subsection (a) shall be in a format prescribed by the commissioner.
(c) The description required under subsection (a) shall include a statement that informs the aggrieved person of the aggrieved person's right to file a request for an external review of an adverse determination or final adverse determination with the carrier. The statement shall include the telephone number and address of the commissioner.
(d) In addition to subsection (b), the statement shall inform the covered person that, when filing a request for an external review, the covered person will be required to authorize the release of any medical records of the covered person that may be required to be reviewed for the purpose of reaching a decision on the external review.
