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Thank you for your interest in becoming a TennCare/Medicaid Provider.
This section has been designed to assist all providers in obtaining the necessary forms needed for enrollment in the TennCare program (in order to receive reimbursement for both TennCare and Medicare/Medicaid cross-over claims).
Select the appropriate application packet from the links below. Checklists are to assist you in completing and returning the correct documents. Applications cannot be processed without ALL documentation.
The forms from this site should be completed and returned to:
Department of Finance & Administration
Bureau of TennCare
Attn: Provider Enrollment
310 Great Circle Road
Nashville, TN 37243-1700 |
Follow the link to obtain the HCBS Expedited Enrollment
Application for currently contracted providers:
TennCare Providers Forms
Follow the link to contact your area agency
to obtain the HBCS Provider Agreements.
Area Agency on Aging and Disability
www.tennessee.gov/comaging/localarea.html
Copies of all renewals to include licenses, certifications, and/or accreditations must be forwarded to the TennCare/Medicaid Provider Enrollment Office annually or upon required due dates. Please allow 15 business days to process a completed application. Incomplete applications will be returned to the provider office within 7 days of receipt.
PROVIDER SERVICES MCC ENROLLMENT STATEMENT
Those providers who do not bill Medicare/Medicaid, but wish to enroll with a TennCare Managed Care Organization (MCO) will be required to follow the same application process.
The provider number issued to you will be for identification purposes only. To receive reimbursement for services provided to a TennCare only recipient, you must also enroll with a Managed Care Organization (MCO) of your choice.
Medicare eligible providers who choose to enroll prior to Medicare enrollment will be issued a state identification number for presentation to the MCO. This number will entitle the provider to participate with the MCO only. The effective date of participation will be the signature date of the application.
Providers who qualify to receive Medicare numbers must continue the application process with Medicare. Medicare will notify the TennCare Provider Enrollment office of enrollment in their program via a copy of your Medicare welcome letter. It is the responsibility of the provider to notify TennCare of the desire to participate in the Medicare/Medicaid crossover program.
Providers who have already received a Medicare number on or before July 15, 2007 will not need to apply for an MCO identification number. Your number assigned by Medicare for Medicaid crossover reimbursement can be used to present to the MCO of your choice upon enrollment by this office. You must complete the enrollment process and a Medicaid number will be assigned to you. Upon successful completion of the enrollment process, you will be issued a Medicaid billing number. This number will allow you to bill the Bureau of TennCare for Medicare/Medicaid crossover services. You may also submit this number to a Managed Care organization (MCO) of your choice if you wish to participate with a TennCare Managed Care Organization.
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