How to Become a Credentialed Provider for...
- Katie Beckett - Part A, Katie Beckett - Part B
- 1915c
- Employment and Community First (ECF) CHOICES
- ECF Provider who provide CHOICES Waiver Services
Provider Credentialing Application Forum
The Provider Credentialing Application Forum is for potential providers seeking to provide services through the following programs administered by the Department of Intellectual and Developmental Disabilities (DIDD) and Managed Care Organizations (MCOs): Katie Beckett-Part A, Katie Beckett--Part B,1915c Home and Community-Based Services Waivers, Employment and Community First (ECF) CHOICES, and CHOICES. The purpose of the Forum is for you to receive information about DIDD and its mission; to learn more about the program services and the application process; to obtain guidance on questions about the application; and to ensure clarity on information provided in the application instructions.
While not mandatory, attendance, is highly encouraged. The information provided at the meeting can significantly help you understand the provider credentialing applications and increase your chances of submitting a successful application.
Provider Credentialing Application Forum Dates
The Provider Credentialing Applicant Forums are scheduled two (2) times within a quarter from 12:30pm -3:00pm CST. The Forums are virtual, on the day and time of the meeting click the meeting date and follow the details to join.
Time: 12:30pm - 3:00pm
Microsoft Teams meeting
Join on your computer, mobile app or room device
Click here to join the meeting
Meeting ID: 215 760 435 509
Passcode: Ttvhvf
Download Teams | Join on the web
Join with a video conferencing device
Video Conference ID: 112 812 273 4
Or call in (audio only)
+1 629-209-4396,,155703349# United States, Nashville
Phone Conference ID: 155 703 349#
Time: 12:30pm - 3:00pm
Microsoft Teams meeting
Join on your computer, mobile app or room device
Click here to join the meeting
Meeting ID: 213 520 486 67
Passcode: w2DAJv
Download Teams | Join on the web
Join with a video conferencing device
Video Conference ID: 118 745 003 6
Or call in (audio only)
+1 629-209-4396,,425482521# United States, Nashville
Phone Conference ID: 425 482 521#
Provider Credentialing Applications
Application Submission
- See the Submission Links below, submit the application to the region you are requesting to provide the service.
- If requesting to provide services in multiple regions, submit the application to the region in which your main office is located.
- Note: When naming your application include the name of your organization as part of the title in the uploaded document each time you submit information. Example: ABC application, ABC background checks, ABC Disclosure form, etc.
- Note: If you decide to upload a ZIP FILE. Please ensure the file states the name of your organization.
- DIDD will email confirmation of your application within two (2) business days. It is very important you contact DIDD if you do not receive this email.
- Please allow 30 calendar days before requesting the status of your application.
- For questions, contact the DIDD Provider Enrollment Coordinator by email at DIDDProvider.Application@tn.gov or by phone at (615) 532-6530
Submission Links:
East TN Region OwnCloud Link: https://tncloud.tn.gov/owncloud/index.php/s/xlvnxMJ64D4z0Gz
Password: upload
Middle TN Region OwnCloud Link: https://tncloud.tn.gov/owncloud/index.php/s/mHNGfeP0oq6B9Uu
Password: upload
West TN Region OwnCloud Link: https://tncloud.tn.gov/owncloud/index.php/s/PGWdmqFkXRY0XFN
Password: upload
Very Important: The Prerequisites must be completed prior to submission of your Credentialing application. Please see the Prerequisites section of the application.
- New Provider Credentialing Application
- Expansion Credentialing Application
- MCO Contract and County Expansion Request Form
- Attachment 1: Credentialing Standards
- Attachment 2: Licensing Requirements
- Attachment 3: Provider Credentialing Policy Req
- Attachment 4: Service Definitions
- Disclosure Form for Provider Person
- Disclosure Form for Provider Entities
- Substitute W9
- W-9 Form
- TN Non-Residential Self-Assessment
- TN Residential Provider Self-Assessment
- Submitting a National Criminal Background Check to DIDD
Additional Resources:
- DIDD Available Service Rates
- Katie Beckett Available Service Rates
- Title VI of the Civil Rights Act of 1964 Annual Training
If you have any questions, you may contact Linda Maurice at DIDDProvider.Application@tn.gov