Amends TCA Title 56 and Title 63, Chapter 1.
Tennessee SB1063 amends existing laws regarding notification requirements for health care providers and utilization review agents concerning prior authorization requests. It affects health care providers, patients, and health insurance entities by extending the notification period from five business days to seven calendar days, limiting notifications to communications between providers and patients' health insurance entities, and removing the requirement for a summary of communications. Additionally, it mandates that if a provider fails to submit requested information within the specified timeframe, the utilization review organization must notify the enrollee of the request for further information.
Tennessee SB1063 amends existing laws regarding notification requirements for health care providers and utilization review agents concerning prior authorization requests. It affects health care providers, patients, and health insurance entities by extending the notification period from five business days to seven calendar days, limiting notifications to communications between providers and patients' health insurance entities, and removing the requirement for a summary of communications. Additionally, it mandates that if a provider fails to submit requested information within the specified timeframe, the utilization review organization must notify the enrollee of the request for further information.
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