Becoming a Qualified Hospital for Hospital PE
The Hospital PE program is entirely voluntary for hospitals. To participate, a hospital must:
- Participate in the TennCare Medicaid program and maintain a network provider agreement with at least one TennCare Managed Care Organization (MCO);
- Be signed up for TennCare Online Services;
- Be located in Tennessee;
- Make determinations consistent with policies and procedures of the state;
- Comply with all training requirements; and
- Comply with all performance standards.
To sign up for the Hospital PE program, a hospital must:
- Complete the Application to Become a Qualified Entity ;
- Sign up for TennCare Online Services if you have not already done so*;
- Register all employee users with TennCare Online Services**;
- Complete the Hospital PE Information Contact Survey;
- Complete, sign, and date the Memorandum of Understanding ;
- Email both the completed Application to Become a Qualified Entity and the signed MOU to HospitalPE.TennCare@tn.gov or fax these materials to 615-734-5325.
* If you do not know whether your facility is signed up for TennCare Online Services (formerly know as TN Anytime), email the TennCare Online Services Help Desk at TCOS.Help@tn.gov.
** After setting up the account and obtaining access, the hospital IT administrator can go online and click the “Password and User Help” link on the bottom right corner of the login page to request additional users or to manage existing users.
Questions? Email HospitalPE.TennCare@tn.gov.
A special note regarding newborns (June 10, 2016): TennCare implemented a Newborn PE program on August 18, 2014. In the interest of expediency, we implemented the Newborn PE program without executing formal agreements with participating hospitals. In the coming months, TennCare will circulate a Newborn PE agreement, which hospitals must execute to continue to perform Newborn PE determinations. Additionally, these hospitals must begin using a new interface at TennCare Online Services later this year. However, hospitals that participate in the Hospital PE program and sign a Hospital PE agreement will not need to sign a second agreement for Newborn PE – and they can use the Hospital PE interface for all PE transactions (including those for newborns).