Know Your Rights: Independent Reviews of Medical Necessity Decisions
Most BlueCross BlueShield of Tennessee members have the right to request a review by an independent third party of medical necessity decisions*. You can learn more about how your specific benefit plan handles requests for independent reviews in your benefit materials or Evidence of Coverage.
*Grandfathered plans are not required to provide independent review. Refer to the Grievance or Appeals section in your Evidence of Coverage for more information