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DCS Immediate Pharmacy Eligibility

STATE OF TENNESSEE BUREAU OF TENNCARE
310 Great Circle Drive NASHVILLE, TN 372431

Important Notice for all TennCare Pharmacy Providers

The Department of Children's Services (DCS) and TennCare have developed a process designed to provide immediate TennCare eligibility for children who recently entered state protective custody.

On behalf of the child, pharmacy providers will be presented a letter from TennCare Select, administered by BlueCross BlueShield of Tennessee, stating the child is eligible for TennCare during a specific 45-day window of time while their TennCare eligibility is determined.

If you are presented with one of these letters and a prescription for the child, please check eligibility on the TennCare Select or Consultec claims systems. The member should generally be loaded on the system, but if not, please fill that prescription and retain a copy of the letter for your records.

Within 3 to 5 days of filling that prescription, the child will be entered into the TennCare Select and SXC processing systems and the pharmacy claim(s) may be billed online for payment.

Listed below are examples of the letters that may be presented to your pharmacy for immediate eligibility. Click on the appropriate link for a pdf copy. If you have questions about this process or if you encounter any problems with pharmacy claims payment related to immediate eligibility for these DCS children, please call 1-888-816-1680 (for BHO drugs) or 1-800-451-9147 (for other prescriptions) for assistance. Thanks for your cooperation and your continued, valuable participation in the TennCare program.