§ 56-7-602. Part definitions.

TN Code § 56-7-602 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(1) “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;

(2) “Commissioner” means the commissioner of commerce and insurance;

(3) “Comparable healthcare service” includes, but is not limited to:

(A) Physical and occupational therapy services;

(B) Radiology and imaging services;

(C) Laboratory services; and

(D) Infusion therapy;

(4) “Department” means the department of commerce and insurance;

(5) “Health plan” means health insurance coverage as defined in § 56-7-109;

(6) “Healthcare entity” means:

(A) Any healthcare facility licensed under title 33 or 68; and

(B) Any healthcare provider licensed under title 63 or 68;

(7) “Insurance carrier” or “carrier” means a health insurance entity as defined in § 56-7-109; and

(8) “Shopping and decision support program” means the program established by a carrier pursuant to this part.