Information Systems Policies
- Claims Paid With Zero Paid Amount (pdf, 159kb)
- Definition of TennCare Duplicate Encounters (pdf, 170kb)
- Encounter File Naming Standard (pdf, 168kb)
- Encounter Line Items Spanning More Than One Date of Service (pdf, 166kb)
- Encounter Sequencing Within Managed Care Contractor Transaction Files (pdf, 157kb)
- Header versus Detail as a Data Source (pdf, 163kb)
- MCC Payments Made Directly to Members (pdf, 154kb)
- MCC Provider Enrollment Files (pdf, 162kb)
- NDC Submission for HCPCS (pdf, 227kb)
- Proper Reporting of Covered and Non-Covered Days (pdf, 155kb)
- Provider Identification Usage on Submitted Transactions (pdf, 173kb)
- Receipt of MCC Transaction Files (pdf, 157kb)
- Referring Provider Usage (pdf, 221kb)
- Required Encounter Information Submitted to TennCare (pdf, 134kb)
- Requirement of NPI (pdf, 209kb)
- Reuse of Internal Control Number by Managed Care Contractors (pdf, 159kb)
- Revenue Codes Requiring Surgical Code (pdf, 318kb)
- Services Paid For More Than Allowed Amount (pdf, 133kb)
- Services Paid For More Than Billed Amount (pdf, 141kb)
- TPL Carrier Codes (pdf, 151kb)
- Void and Replacement Encounter Submission (pdf, 179kb)
