Tennessee: Start Here
Beginner guide for Tennessee—HealthCare.gov, TDCI external review, PA Fairness Act & Ch. 56-61 appeals.
Read guideState playbook
Tennessee
State insurers, legislation, and appeal resources for patients and advocates in Tennessee.
4 guides
Tennessee Prior Authorization Law
PA Fairness Act—7-day deemed approval, 17-day cap, 72-hour urgent; excludes TennCare & ERISA.
Read guideTennessee Health Insurance Appeals and Grievances
Ch. 56-61—30/60-day decisions, optional second level, deemed exhaustion, path to IRO.
Read guideTennessee External Review (IRO)
Binding on plan—6-month filing with carrier, 40-day IRO decision, 72-hour expedited.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- BlueCross BlueShield of Tennessee
- Ambetter of Tennessee (Celtic)
- Cigna Healthcare (Tennessee)
- Oscar Health (Tennessee)
- UnitedHealthcare (Tennessee)
- Alliant Health Plans
- HealthCare.gov (Tennessee Marketplace)
- TennCare
External appeals
After internal appeal, for eligible Tennessee fully insured plans only.
- TDCI — external review & consumer help
- Medicaid — TennCare appeals