Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee

Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee

Request to Commissioner for Independent Review of Disputed Tenncare Claim is a legal document that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee.

FAQ

Q: What is a Request for Independent Review of a Tenncare Claim?A: A Request for Independent Review is a formal request to the Commissioner of Tennessee for a review of a disputed Tenncare claim.

Q: Who can submit a Request for Independent Review?A: Any individual or provider who disagrees with a decision made by Tenncare regarding a claim can submit a Request for Independent Review.

Q: How can I submit a Request for Independent Review?A: You can submit a Request for Independent Review by completing a specific form provided by Tenncare and mailing it to the Commissioner at the address specified on the form.

Q: What information do I need to include in my Request for Independent Review?A: You should include your name, contact information, the reasons for your dispute, and any supporting documentation or evidence.

Q: What happens after I submit a Request for Independent Review?A: After receiving your request, the Commissioner will assign an independent reviewer to review your case and make a determination.

Q: How long does the independent review process take?A: The review process should be completed within 45 days from the date your complete request is received by the Commissioner.

Q: What if I disagree with the outcome of the independent review?A: If you disagree with the outcome of the independent review, you may have the option to pursue further appeals or legal actions.

Q: Is there a fee to submit a Request for Independent Review?A: No, there is no fee to submit a Request for Independent Review of a Tenncare claim.

ADVERTISEMENT

Form Details:

  • Released on January 7, 2016;
  • The latest edition currently provided by the Tennessee Department of Commerce and Insurance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Tennessee Department of Commerce and Insurance.

Download Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee

4.3 of 5 (61 votes)
  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee

    1

  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 2

    2

  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 3

    3

  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 4

    4

  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 1
  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 2
  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 3
  • Request to Commissioner for Independent Review of Disputed Tenncare Claim - Tennessee, Page 4
Prev 1 2 3 4 Next
ADVERTISEMENT

Related Documents