Form IN2001 Request to Commissioner for Independent Review of Disputed Provider Claim - Tenncare & Coverkids Programs - Tennessee

What Is Form IN2001?

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 form IN2001?A: Form IN2001 is a request to the Commissioner for Independent Review of a disputed provider claim in the Tenncare & Coverkids Programs in Tennessee.

Q: Who can use form IN2001?A: The form can be used by providers in the Tenncare & Coverkids Programs in Tennessee who have a disputed claim.

Q: What is the purpose of form IN2001?A: The purpose of form IN2001 is to request an independent review of a disputed provider claim in the Tenncare & Coverkids Programs in Tennessee.

Q: How should I fill out form IN2001?A: You should fill out form IN2001 completely and provide all necessary information and documentation related to the disputed claim.

Q: Is there a deadline to submit form IN2001?A: Yes, there is a deadline to submit form IN2001. The form must be submitted within 30 calendar days from the date of the initial adverse notice.

Q: What happens after I submit form IN2001?A: After you submit form IN2001, the Commissioner will review the request for independent review and make a determination.

Q: Can I appeal the decision made by the Commissioner?A: Yes, if you are dissatisfied with the decision made by the Commissioner, you have the right to appeal the decision through the administrative hearing process.