Provider Enrollment Frequently Asked Questions (FAQs)

What is a Medicaid ID and when can I use it?

Before a provider can be considered for participation in TennCare, registration with the Division of TennCare is required. TennCare issues a Medicaid ID to eligible providers who have completed the registration process. Without a valid, active Medicaid ID, providers cannot be considered for contracting with any TennCare Managed Care Organization or receive payment for services rendered to TennCare enrollees. Additionally, prescribers must have a valid, active Medicaid ID for TennCare to make payment for a covered prescription in accordance with 42 CFR 455.410. Providers must contract with each TennCare MCO separately to become an in-network provider with each health plan to begin seeing TennCare members.

Whom do I call to get a contract with each TennCare MCO?

Call the Amerigroup Provider Services Line at 800-454-3730
Call the BlueCare Provider Services Line at 800-468-9736
Call the UnitedHealthcare Community Plan Provider Services Line at 800-690-1606
Call the TennCare Select Provider Services Line at 800-276-1978

How can I find out who my assigned MCO Provider Relations Representative is for each MCO?

For BlueCare, you can look up your assigned at My BlueCross Contact
For UHCCP, you can look up your assigned PR Rep on their website
For Amerigroup, call the Amerigroup Provider Services Line at 800-454-3730

When can a TennCare member change their assigned MCO and when will this change take effect?

A member can request to change their MCO during the MCO change period for the region where they live.

East TN – MCO change period is July.
Middle TN – MCO change period is May.
West TN – MCO change period is March.

Once a TennCare member requests to change their MCO, the change will take effect on the 1st of the
following month.

For example – If the member lives in Middle TN, their MCO change will take effect on July 1st.

I am an individual provider, and I do not have a Medicaid ID. What should I do?

Individual providers must register electronically with TennCare. Please visit the TennCare Provider Registration website and follow the instructions there for Individual Providers. Enter requested information to place the provider on the CAQH roster for TennCare. Instructions will be sent to guide individual providers through the process of entering data into the CAQH Universal Provider Datasource. Once data is received from CAQH and approved, a Medicaid ID will be assigned. TennCare will automatically receive profile data from CAQH each time you update.

I am an individual provider, and I already have a valid active Medicaid ID. What should I do?

Current individual providers must re-validate by registering electronically with TennCare. Please follow instructions for a new provider in #2 above. Individual providers only need to visit the TennCare Provider Registration website once. TennCare will then receive your profile data from CAQH automatically each time you make an update.

I represent a group practice, and I do not have a Medicaid ID for my group. What should I do?

Group providers must register with TennCare. Please visit TennCare Provider Registration website and follow the instructions given for “All Other Provider Registration Information”. You will establish an account and be able to make address changes, add individual providers to your roster, and update information on your Disclosure of Ownership declaration to TennCare electronically. New group practices will be assigned a Medicaid ID after successful completion and approval from TennCare.

I am a provider group, and I already have a valid active Medicaid ID. What should I do?

Current single and multi-specialty group providers must revalidate by registering with TennCare. Please visit TennCare Provider Registration website and follow the instructions given for “All Other Provider Registration Information” as listed in #4 above. You will establish an account and be able to provide updates such as address changes, add individual providers to your roster and make updates to information on your Disclosure of Ownership declaration to TennCare electronically.

I am not a group provider, and I am not an individual provider as described above, and I do not have a Medicaid ID for my entity. What should I do?

Entity providers must register with TennCare. Please visit TennCare Provider Registration website and follow the instructions given for “All Other Provider Registration Information”. You will establish an account and be able to provide updates such as address changes, add individual providers to your roster and make updates to information on your Disclosure of Ownership declaration to TennCare electronically. New group practices will be assigned a Medicaid ID after successful completion and approval from TennCare.

I completed my registration request and was assigned a new Medicaid ID even though I am already an existing Medicaid provider and have a Medicaid ID?

Occasionally there have been some occurrences where this will happen. If you do receive a new Medicaid ID, please notify the TennCare Provider Services call center at 1-800-852-2683 option 5 or email us at Provider.Registration@tn.gov. We will research and ensure the correct Medicaid ID is associated with our profile. If the provider’s previous Medicaid ID is active and correctly registered the database will be updated to reflect the old Medicaid ID. This is not always the case, and each instance must be reviewed.

I am a provider and saw a patient who did not inform our office that they have TennCare. Can we bill them since they didn’t tell us they have TennCare insurance?

No. It is the provider’s responsibility to determine whether a patient is a TennCare enrollee or not.

What if I have other questions regarding provider registration?

Please contact TennCare Provider Services at 1-800-852-2683 and choose option 5 or email Provider.Registration@tn.gov