Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee

Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee

What Is Form IN-2004?

This is a legal form that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is an IN-2004 Provider Complaint?A: The IN-2004 Provider Complaint is a form used to file a complaint regarding a Medicare Advantage Special Needs Plan (Ma-Snp).

Q: Who can file an IN-2004 Provider Complaint?A: Healthcare providers who participate in the Medicare Advantage Special Needs Plan (Ma-Snp) in Tennessee can file an IN-2004 Provider Complaint.

Q: What is a Medicare Advantage Special Needs Plan (Ma-Snp)?A: A Medicare Advantage Special Needs Plan (Ma-Snp) is a type of Medicare Advantage plan that provides specialized care for individuals with specific health conditions or needs.

Q: What can I file a complaint about using the IN-2004 form?A: You can file a complaint about issues such as billing problems, quality of care, customer service, or any other concerns related to the Medicare Advantage Special Needs Plan (Ma-Snp).

Q: How long does it take to process an IN-2004 Provider Complaint?A: The processing time for an IN-2004 Provider Complaint may vary, but Medicare aims to respond to all complaints within 30 days.

Q: What should I do if my complaint is not resolved through the IN-2004 Provider Complaint process?A: If your complaint is not resolved through the IN-2004 Provider Complaint process, you can escalate it to the appropriate regulatory or oversight authority.

Q: Is there a deadline for filing an IN-2004 Provider Complaint?A: There is no specific deadline mentioned for filing an IN-2004 Provider Complaint, but it is advisable to file it as soon as possible after experiencing the issue.

Q: Can I file an IN-2004 Provider Complaint anonymously?A: No, the IN-2004 Provider Complaint requires you to provide your name and contact information.

Q: Can I file an IN-2004 Provider Complaint on behalf of someone else?A: Yes, you can file an IN-2004 Provider Complaint on behalf of a patient or another healthcare provider, with their consent.

ADVERTISEMENT

Form Details:

  • Released on September 1, 2021;
  • The latest edition provided by the Tennessee Department of Commerce and Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form IN-2004 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Commerce and Insurance.

Download Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee

4.3 of 5 (21 votes)
  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee

    1

  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee, Page 2

    2

  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee, Page 3

    3

  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee, Page 1
  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee, Page 2
  • Form IN-2004 Provider Complaint: Medicare Advantage Special Needs Plan (Ma-Snp) - Tennessee, Page 3
Prev 1 2 3 Next
ADVERTISEMENT