As used in this part, unless the context otherwise requires:

(1) “Health care provider” or “provider” means any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11, with whom the health insurance entity has an express and valid network provider agreement or contract;

Terms Used In Tennessee Code 56-7-3301

  • Contract: A legal written agreement that becomes binding when signed.
  • Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
  • provider: means any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11, with whom the health insurance entity has an express and valid network provider agreement or contract. See Tennessee Code 56-7-3301
(2) “Health insurance entity” has the same meaning as in § 56-7-109; and
(3) “Reasonably accurate” means information determined through application by the health insurance entity of contract rates, fee schedules and reimbursement rules and policies in effect as of the date inquiry is made by the provider.
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