How to Become a Credentialed Provider

The Provider Credentialing Application Forum is for potential providers seeking to provide services through the following programs administered by the Department of Disability and Aging (DDA) 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 DDA 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 Forums are held quarterly, two (2) times within the same month, Central Standard Time (CST). The Forums are virtual, on the day and time of the meeting, click the meeting date and follow the detail to join.

Credentialing  Protocol

Application Submission

1.   Submit the application to DDA.Provider.Application@tn.gov

2.   Type in the Subject section your organization’s name and the region (West, or Middle, or East, or Statewide*) you are requesting the service

* Statewide applies If you are applying for more than one region

3.   For each uploaded document label the document’s name. See Attachment 1 for the list of appropriate documents to upload according to your selected service(s).

For Example: 

• Credentialing Application
• TN Business State License and/or County of TN Business License, as applicable  
• Disclosure Form 
• Tax Forms (W-9, IRS 147c and Substitute W-9)

If each uploaded document is not named this may delay the downloading process and impact credentialing of your application. Graphic files such as:  JPEG (photo) or TIFF, will not be accepted.

Note: Due to documentation uploading capacity limitation, you may need to continue uploads onto more than one submission. Remember for each submission, type in the Subject line type your organization’s name and the region (West, Middle, or East, or Statewide*) you are requesting the service.  Also label the name of each uploaded document.

* Statewide applies If you are applying for more than one region

Note: If you decide to upload a ZIP FILE. Please ensure the uploaded file states the name of your organization and the region. Also label the name of each document within the ZIP FILE.

4.   DDA will email confirmation of your application within two (2) business days. It is very important you contact DDA if you do not receive this email.

5.   Please allow 30 calendar days before requesting the status of your application. 

6.   For questions, contact the DDA Provider Enrollment Coordinator by email at DDA.Provider.Application@tn.gov or phone (615) 532-6530

ReCredentialing Protocol

• Application for Recredentialing
  • Instructions for Completing Recredentialing Application
  • Attachment 1: Recredentialing Review Requirements
  • Attachment 2: Licensure Requirements
  • Attachment 3: Policy Requirements
• Recredentialing Review Checklist

• DDA 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 DDA.Provider.Application@tn.gov