Member Resources

Current TennCare members can contact their assigned Managed Care Organization (MCO) using the following links to learn more about their current benefits and services and apply for Long-Term Services and Support (LTSS) programs:

• Wellpoint (formerly known as Amerigroup)
• BlueCare
• UnitedHealthcare

If you are not currently a TennCare Medicaid member and are interested in learning more about and applying for LTSS programs, use the links below to find the correct contact information for the region or county where the applicant resides.

• DIDD Regional Office Contacts

The Tennessee Department of Intellectual & Development Disabilities (DIDD) can provide information and application assistance for the Employment and Community First (ECF) CHOICES and 1915(c) home and community-based services (HCBS) waiver programs that support individuals with I/DD diagnoses.

• AAAD Regional Office Contacts

The Area Agencies on Aging and Disabilities (AAAD) can provide information and application assistance for the CHOICES program that supports adults (age 21 and older) with a physical disability and seniors (age 65 and older).

Free communication assistance—including sign language or oral interpretation and assistive technology—is available for individuals who need to attend a TennCare meeting, training, or hearing. Please complete this form to let us know what help you need.

Health and safety concerns for members receiving either Home and Community Based Services (HCBS) through CHOICES, ECF CHOICES, 1915(c) waiver, and Katie Beckett programs or Intermediate Care Facilities should report the event to the Reportable Events Management (REM) system for assessment and/or investigation. Reportable events include, but are not limited to:

• Allegations of abuse (including physical, sexual, emotional, or psychological), neglect, and/or exploitation
• Unexplained or unexpected deaths
• Suspicious injuries or injuries with an unknown cause
• Behavioral crisis events requiring restraints, emergency psychotropic medication, or crisis intervention
• Suspected criminal conduct
• Member engagement with law enforcement
• Physical or sexual aggression by the member
• Self-injurious behavior or suicide attempt
• Medical events outside of a diagnosed chronic condition that require emergency room or urgent care facility treatment
• Missing person
• Medication variance or omission
• Fall with injury
• Unsafe environment
• Vehicle accident
• Emergency situations that result in harm or risk of harm to member, including fire, flooding, and serious property damage

Reportable events shall be reported to DIDD via:

• Phone: DIDD Abuse Hotline 888-633-1313
• Email: DIDD.ReportableEvents@tn.gov

Department of Intellectual and Developmental Disabilities Reportable Event Form

For more information regarding Reportable Events Management, please visit the DIDD website.

LTSS program members may file a complaint or grievance about matters related to their services or providers, including:

• The quality of care or services provided,
• Provider relationships or interactions, such as rudeness by a provider/employee, and
• Failure to respect the member’s rights.

Members may also file a complaint or grievance to dispute an extension of time proposed by the MCO for making a decision related to service authorizations.

Please Note: Complaints or grievances should not be filed in the event of a denial, reduction, or termination of a member’s services (also known as an Adverse Benefit Determination, or ABD). Members who have been notified of a reduction or termination of services shall receive information about how to file an appeal of the determination and the state fair hearing process.

Members receiving LTSS through the CHOICES or ECF CHOICES programs may file a complaint in one of the following ways:

• Contact your assigned MCO Care Coordinator or Support Coordinator
• Contact your MCO and ask to speak to the CHOICES Consumer Advocate or ECF CHOICES Member Advocate:
  • Wellpoint (formerly known as Amerigroup) 833-731-2153 (TTY 711)
  • BlueCare: (800) 468-9698
  • UnitedHealthcare: (800) 690-1606
• Contact TennCare’s Beneficiary Support System (Disability Rights Tennessee)
  • Phone: (888) 723-8193
  • Email: benefitshelp@disabilityrightstn.org
  • Online Form: https://www.ltsshelptn.org
• Contact the Long-Term Care (LTC) or Community Living Supports (CLS) Ombudsman
  • LTC Ombudsman District Contacts
    For members receiving LTSS in a nursing facility or a community-based residential alternative, including assisted care living facilities and adult care homes.
  • CLS Ombudsman: (866) 836-6678
    For members receiving CLS or CLS-Family Model services. (These services are available to members in CHOICES Groups 2 and 3 and ECF CHOICES Groups 5 and 6.)

Members receiving LTSS through a 1915(c) HCBS waiver may file a complaint in one of the following ways:

• Contact your Independent Support Coordinator (ISC)
• Contact the DIDD Customer-Focused Service (CFS) Unit
  • Phone: (833) 696-2089
  • Email: DIDD.CustomerFocusedService@tn.gov
• Contact the TennCare LTSS Director of Intellectual Disability Services
  • Phone: (615) 837-5577
  • Email: Erika.Irvine@tn.gov