This version of the form is not currently in use and is provided for reference only. Download this version of Form IN-2004 for the current year.
This is a legal form that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the IN-2004 Provider Complaint form?
A: The IN-2004 Provider Complaint form is a form used to file a complaint regarding a Medicare Advantage Special Needs Plan (ma-SNP) in Tennessee.
Q: What is a Medicare Advantage Special Needs Plan (ma-SNP)?
A: A Medicare Advantage Special Needs Plan (ma-SNP) is a type of Medicare Advantage plan that is designed to provide specialized care and coverage for individuals with specific health needs or conditions.
Q: Who can file a complaint using the IN-2004 Provider Complaint form?
A: Healthcare providers who have a complaint regarding a Medicare Advantage Special Needs Plan (ma-SNP) in Tennessee can file a complaint using the IN-2004 Provider Complaint form.
Q: What kind of complaints can be filed using the IN-2004 Provider Complaint form?
A: The IN-2004 Provider Complaint form can be used to file complaints regarding various issues related to a Medicare Advantage Special Needs Plan (ma-SNP), such as denials of coverage, delays in services, billing issues, and quality of care concerns.
Q: How can I obtain the IN-2004 Provider Complaint form?
A: The IN-2004 Provider Complaint form can be obtained by contacting the appropriate regulatory authority or agency responsible for overseeing Medicare Advantage Special Needs Plans (ma-SNPs) in Tennessee.
Q: What should I do if I have a complaint regarding a Medicare Advantage Special Needs Plan (ma-SNP) in Tennessee?
A: If you have a complaint regarding a Medicare Advantage Special Needs Plan (ma-SNP) in Tennessee, you should fill out the IN-2004 Provider Complaint form and submit it to the appropriate regulatory authority or agency.
Form Details:
Download a fillable version of Form IN-2004 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Commerce and Insurance.