Providers

First, TennCare is the state of Tennessee’s managed Medicaid (TennCare) and Children’s Health Insurance Program (CoverKids) agency. A TennCare provider then is any health professional that provides services to TennCare or CoverKids members, which are primarily:

• low-income individuals such as pregnant women,children, 
• caretaker relatives of young children, or
• older adults and adults with disabilities.
  

If you will be providing services to TennCare members (patients) then you need to enroll with TennCare to receive a Medicaid ID. Once the TennCare Medicaid ID is established, then you can begin contracting with the Managed Care Organization(s) for claims payment.

TennCare services are offered through managed care entities. Medical, behavioral and long-term care services are covered by "at risk" Managed Care Organizations (MCOs) in each region of the state, and each participating MCO creates their own contracts with providers, maintains their own fee schedules, processes their own claims, and has their own in-network specialists and providers.

You can contact the Provider Relations hotline at each of the MCOs in order to find information about fee schedules, becoming a TennCare Provider, or finding TennCare Specialists. The contact information for the MCOs is listed under health plans.

• MCO Statewide Contract
• Health Plans
• Dental Benefits
• Pharmacy Benefits Manager

We welcome the opportunity to work with you to provide medically necessary health care services to eligible TennCare members.

Please call the TennCare Provider Operations Center toll-free: 800-852-2683
Monday to Friday 8 a.m. - 4:30 p.m. CST.

Or email us at Provider.registration@tn.gov

• Box 420 - Special Handling (claims requiring manual review)
• Box 430 - UB-04 Claim Forms (LTSS)
• Box 460 - CMS-1500 Claim Forms
• Box 470 - UB-04 Claim Forms
• Box 480 - UB-04 Claim Forms (LTSS)
• Box 490 - General Claims
• Box 580 - General Correspondence
• Box 740 - General Correspondence/ Applications (Green Forms)/ Medical Eligibility (ME Forms)
• Box 778 - Attestation (PCP Bump)
• Box 820 - MCO Change
• Box 830 - Fiscal Budget/ TPL
• Box 850 - General Correspondence
• Box 000593 - TSU
• Box 1700 - Adjustments/Patient Liability
• Box 22630 - Member Services