Frequently Asked Questions
What do we do?
The TennCare Oversight Division licenses and regulates the managed care companies that contract with the TennCare program to provide medical, behavioral, and long term care services.
The TennCare Oversight Division performs reviews of the TennCare managed care companies to ensure they are financially sound and operate in compliance with their TennCare contract and applicable laws, including prompt and accurate payment of claims submitted by TennCare providers.
- Managed Care Organization Financial Reports
- Managed Care Organization Examination Reports
- Prompt Pay Compliance Reports
The TennCare Oversight Division offers 2 processes to help TennCare providers resolve disputes with TennCare managed care companies: Providers can submit a complaint to the Division or they can request an independent review of a denied claim.
- Provider Complaint Process
- Independent Review Process
- Independent Review Annual Report
- Provider Complaints Quarterly Summary
Do you want to apply for TennCare?
The TennCare Oversight Division does not handle applications for TennCare coverage. That is done by the Department of Finance and Administration’s Division of TennCare.
Are you a TennCare member who wants to file a Medical Appeal?
The TennCare Oversight Division does not handle medical appeals by TennCare members. That is done by the Department of Finance and Administrations, Division of TennCare.