§ 56-7-601 Short title
§ 56-7-602 Part definitions
§ 56-7-603 Shopping and decision support program
§ 56-7-604 Interactive member portal or toll-free phone number for estimate of out-of-pocket estimates
§ 56-7-605 Order for comparable healthcare service upon request
§ 56-7-606 Report on examples of shared savings incentive programs
§ 56-7-607 Promulgation of rules
§ 56-7-608 Applicability of part
§ 56-7-609 Annual total value of incentives
§ 56-7-610 Enrollee price negotiation for out of pocket services
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Terms Used In Tennessee Code > Title 56 > Chapter 7 > Part 6 - Tennessee Right to Shop Act

  • 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. See Tennessee Code 56-7-602
  • carrier: means a health insurance entity as defined in §. See Tennessee Code 56-7-602
  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-7-602
  • Comparable healthcare service: includes , but is not limited to:
    (A) Physical and occupational therapy services. See Tennessee Code 56-7-602
  • Contract: A legal written agreement that becomes binding when signed.
  • Department: means the department of commerce and insurance. See Tennessee Code 56-7-602
  • Emergency medical service: means the service used in responding to the perceived individual need for immediate medical care in order to prevent loss of life or aggravation of physiological or psychological illness or injury. See Tennessee Code 56-7-602
  • Health plan: means health insurance coverage as defined in §. See Tennessee Code 56-7-602
  • Healthcare entity: means :
    (A) Any healthcare facility licensed under title 33 or 68. See Tennessee Code 56-7-602
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
  • Shopping and decision support program: means the program established by a carrier pursuant to this part. See Tennessee Code 56-7-602
  • 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
  • Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105