TN Insurance Bulletin (1996-07-25): Assignment of Benefits to Health Care Providers

DON SUNDQUIST GOVERNOR TO: STATE OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE 500 JAMES ROBERTSON PARKWAY NASHVILLE, TENNESSEE 37243 BULLETIN All Insurance Companies Doing Business in Tennessee DOUGLAS M. SIZEMORE COMMISSIONER FROM: Douglas Sizemore, Commissioner, Department of Commerce and Insuran~ Assignment of Benefits to Health Care Providers RE: DATE: July 25, 1996 It has been brought to the attention of the Department of Commerce and Insurance that written assignments ofbenefits to the health care providers are not being honored by insurance companies. Please note the following code section which is the current applicable Tennessee statute regarding assignments ofbenefits to health care providers: 56-7-120. Assignment of benefits to health care provider. Notwithstanding any provision oflaw, rule, or reb>ulation to the contrary, whenever any policy of insurance issued in this state provides for coverage of health care rendered by a provider covered under title 63, the insured or other persons entitled to benefits under such policy shall be entitled to assign these benefits to the health care provider. Notice of such assignment, unless otherwise provided by contract, must be in writing to the insurer to be effective. This section applies only to assignments of benefits which were provided after July 1, 1992. As used in this section, "health care provider" means a doctor of medicine, osteopathy, chiropractic, podiatry or optometry, a phannacist or pharmacy, a hospital, home health agency, an entity providing infusion therapy services or an entity providing medical equipment services. {Acts 1992, .ph. 918, Title 1; 1993, ch. Ill Title 1.} '\ The last sentence of the current statue referenced above clearly requires an insurance company that has written notice of an assignment of benefits to a health care provider, including; doctor of medicine, osteopathy, chiropractic, podiatry or optometry; to protect their interest vices or an entity providing medical equipment services. {Acts 1992, .ph. 918, Title 1; 1993, ch. Ill Title 1.} '\ The last sentence of the current statue referenced above clearly requires an insurance company that has written notice of an assignment of benefits to a health care provider, including; doctor of medicine, osteopathy, chiropractic, podiatry or optometry; to protect their interest. Many of the concerns received by our department involve an automobile insurer not protecting a health care provider who has received an assignment and so notified the company on medical claims under the auto policy. Please communicate with your respective claim departments to assure that your company is in compliance with 56-7-120 the current statue. ·.'