Additional Resources for Providers
December 2021: TennCare Maternal Health Updates Webinar
Find 2022 updates on the Care Management Form, Care Management and transportation supports, and enhanced reimbursement for mental health screening.
Maternity Provider Checklist – How to maximize TennCare benefits
- Submit the Care Management Notification Form for every pregnant person 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 enrollee’s health plan.
- Inform TennCare Medicaid enrollees of the pregnancy dental benefit. Educate on the safety and benefits of dental hygiene in pregnancy. To learn more and help connect enrollees to a dental provider, visit the Dental Benefits for Pregnant and Postpartum Medicaid Enrollees page.
- Screen pregnant individuals 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. To learn more information about how you can receive an incentive for up to two routine postpartum care visits, review the TennCare Maternal Health Updates Webinar video or slides.
- Encourage continued health care, whether that’s seeing a PCP or seeing specialists in the extended postpartum period.
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.