Providers
BCBST.com
- NEWS – TennCare Transition in West and East Grand Regions – Letters to providers and frequently asked questions
- QUICK LINKS- Provider Manual -The Volunteer State Health Plan Provider Administration Manual contains comprehensive information regarding BlueCare® operating policies and procedures. The information contained in the manual applies to Providers who care for BlueCare and/or TennCareSelect Members.
- BLUECARE® / TENNCARESELECT-
- Amended and Restated Contractor Risk Agreement – West and East MCO contract
- Provider Initiated Notice - Adverse Action (Electronic Form)
- Provider Initiated Notice - Adverse Action
- Crisis Information
- Disclosure of Ownership & Control Interest Statement
- State Medicaid Director letter
- Present On Admission (POA) Indicators
- Reimbursement For Selected Hospital Acquired Conditions (HACs) Not Present On Admission (POA)
- Reimbursement For Serious Reportable Adverse Events (Never Events)
- P4 Pathway Oncology Program
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TennCare Programs & Services
CaringStart Maternity Management Program
The CaringStart Maternity Management program partners with providers to improve the health and birth outcomes of our pregnant members.
CareSmart Disease Management Programs
CareSmart Disease Management Programs partner with providers to improve the health and quality of life for members with chronic disease and illness. The programs emphasize the importance of primary care provider collaboration and involvement.
High Tech Imaging Services
As of November 1, 2008, prior authorization may be required for CT, CTA, MRI, MRA, MR Spectroscopy, PET Scans, and Nuclear Cardiology imaging services for BlueCare members in the West Grand Region. These prior authorization requirements will also apply to members in the East Grand Region on January 1, 2009.
Select Community
This is the new TennCare Select program for certain persons with Intellectual Disabilities Members have Nurse Care Managers to assist them with getting their physical and behavioral health needs met. Please click on the link for additional information.
TENNderCare / EPSDT
TENNderCare is a program for BlueCare and TennCareSelect members under the age of 21. The program provides free Early Periodic Screening, Diagnosis and Treatment (EPSDT) services. Every child under the age of 21 is eligible for TENNderCare services and should receive checkups, even if there is no apparent health problem.
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Important Provider Links
- 2010 Medical Emergency Code List (sorted by description)
- BCBST.com provider news
- Specialty Pharmacy Master Drug List
- VSHP Provider Manual
- Amended and Restated Contractor Risk Agreements
- Formulary Changes Effective 07/01/10
Behavioral Health
BlueCare Providers
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TennCareSelect and SelectKids Providers
