Tennessee Code 71-5-2314 – Payment of claims under TennCare partners program
Terms Used In Tennessee Code 71-5-2314
- State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
This section is intended to ensure the prompt and accurate payment of all claims incurred by providers delivering services to enrollees of the TennCare partners program, and to formalize the resolution of all claims disputes arising under the partners program. Accordingly, the standards and requirements set forth at § 56-32-126(b), shall be applicable to the TennCare partners program. Specifically, all entities contracting with the state in the partners program shall have the same rights and obligations as defined for TennCare health maintenance organizations at § 56-32-126(b). The commissioner of commerce and insurance has the authority to conduct periodic examinations of these entities to verify compliance with this section. Any entity found to be in noncompliance with this section shall be subject to the imposition by the commissioner of the same penalties and other remedies set forth at § 56-32-120.