Additional Resources for Providers

Maternity Provider Checklist – How to maximize TennCare benefits

  • Submit the Care Management Notification Form for every pregnant woman to inform their health plan (Wellpoint (formerly known as Amerigroup) , BlueCare Tennessee, or UnitedHealthcare Community Plan) of the pregnancy and any high-risk characteristics.
  • If you or the patient need additional support, such as care coordination, referrals, or transportation assistance, reach out to the Care Management team of the member’s health plan.
  • Inform TennCare Medicaid members of the pregnancy dental benefit. Educate on the safety and benefits of dental hygiene in pregnancy. To learn more and help connect members to a dental provider, visit the Dental Benefits for Pregnant and Postpartum Medicaid Members page.
  • Screen pregnant women with for mental health concerns using a validated tool. Don’t forget to submit the claim correctly to receive enhanced reimbursement.
  • ACOG recommends two postpartum visits, one within the first 3 weeks of delivery and a more comprehensive visit 4-12 weeks from delivery.
  • Encourage continued health care, whether that’s seeing a PCP or seeing specialists in the extended postpartum period.

Postpartum Incentive

To learn more information about how you can receive an incentive for up to two routine postpartum care visits, please reach out to the health plans:

Related Programs for Pregnant and Postpartum TennCare Members

Within TennCare, there are a variety of programs that may support pregnant and postpartum members. For further information on each program, refer to the information and links below.

Tennessee Health Link

The primary objective of Tennessee Health Link is to coordinate health care services for TennCare members with the highest behavioral health needs. Health Link providers commit to providing comprehensive care management, care coordination, referrals to social supports, member and family support, transitional care, health promotion, and population health management.

Patient-Centered Medical Homes (PCMH)

Patient Centered Medical Homes are a comprehensive care delivery model designed to improve the quality of primary care services for TennCare members, the capabilities of and practice standards of primary care providers, and the overall value of health care delivered to the TennCare population. Looking for your patient’s primary care provider? Find it using TennCare Online Services.

Episodes of Care

The Episodes of Care program rewards high-quality care encourages provider coordination, and disincentivizes ineffective and/or inappropriate care. The perinatal episode of care is triggered by the birth of a live infant and encompasses all pregnancy related care including prenatal visits, lab tests, ED visits, medications, ultrasounds imaging, delivery of the baby, and postpartum care.

To find MCO-specific information, please navigate to the relevant MCO organization below.