RFP 31865-00637
RFP 31865-00637 Main Document
Amendment 1
PREPAID INPATIENT HEALTH PLAN (PIHP)
Procurement Number: 31865-00637
Release Date: November 6, 2023
Summary:
TennCare seeks to select a contractor to maintain a statewide administrative
services only contract for medical services and care management.
Contractor will be required to maintain a statewide network of
providers across all areas of medical and behavioral health services
and pay claims and manage care for the population that is enrolled with
this contractor.
Procurement Library
- PCMH Program Overview
- PCMH Provider Operating Manual
- Annual PCMH Data Report Template
- Quarterly PCMH Provider Report Template - High Volume
- Quarterly PCMH Provider Report Template - Low Volume
- Monthly EPSDT Claims Report Template
- Annual Population Health Outcome Metric Report Template
- Bi-Annual Population Health Report - Data
- Bi-Annual Population Health Report - Narrative
- Annual Provider Satisfaction Survey Report - Letter
- Annual Provider Satisfaction Survey Report - Memo
- Annual Provider Satisfaction Survey Report - Required Questions
- NCQA Standards Guidelines for MCO Accreditation
- COBA with Medicare (Crossover process)
- HIPAA IS Data Transmission 270 Companion Guide
- HIPAA IS Data Transmission 271 Companion Guide
- HIPAA IS Data Transmission 820 Companion Guide
- HIPAA IS Data Transmission 834 Companion Guide
- 30 HIPAA IS Data Transmission 835 Companion Guide
- 30 HIPAA IS Data Transmission 837D Companion Guide
- 30 HIPAA IS Data Transmission 837I Companion Guide
- 30 HIPAA IS Data Transmission 837P Companion Guide