TennCare Provider Resource Board

Your Central Hub for Provider News, Resources, and Announcements

Announcements for Providers

ASD Identification & Diagnosis Training for Pediatric Primary Care Provider

The Tennessee Child and Adolescent Psychiatry Education and Support (TCAPES) Program at the Tennessee Department of Health, in collaboration with the Vanderbilt Kennedy Center’s Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), is offering a free, in-person comprehensive training on the identification and diagnosis of Autism Spectrum Disorder (ASD) for pediatric primary care providers.

What’s included?

  • Expert-led training on ASD diagnosis and best practices
  • A post-workshop Community of Practice for ongoing learning and peer connection
  • Dedicated office hours for personalized guidance and technical assistance
  • STAT kits provided at no cost to participants
  • CME credits available upon completion

Training Details:
Registration is required!
Friday, July 10, 2026
8:00 a.m. – 4:00 p.m. ET

East Regional Health Office
2101 Medical Center Way
Knoxville, TN 37922

Lunch will be provided at no cost to participants. 

Effective July 1, 2027, TennCare's timely filing limit for 1915(c) and ICF/IID claims will be reduced from one (1) year to one hundred twenty (120) days from the date of service.

Providers should ensure their billing processes and internal workflows are updated to meet this new requirement which will be effective for services provided on and after July 1, 2027. Claims submitted more than 120 days after the date of service will be denied for untimely filing.

TennCare will share additional guidance, including the link to the proposed rule change and updated policy language as soon as it is available. TennCare is working on finalizing updates to the current timely filing policy, Please note this still reflects a one-year timeline, but it may help answer any questions that arise related to dates of service.

TennCare will be reaching out individually to providers who regularly file claims 180+ days from the date of service to ensure they are aware of this change and working towards compliance effective July 1, 2027. In the meantime, providers can reach out if they have questions or need assistance preparing for this change.

Thank you for your continued partnership and commitment to serving TennCare members.

Network Provider Claims Audit Notice

SafeGuard Services (SGS), working on behalf of the Centers for Medicare & Medicaid Services (CMS) as the Southeastern Unified Program Integrity Contractor (SE UPIC), will soon begin Medicaid audits of TennCare's Managed Care Plans (MCPs), BlueCare, United Health and Wellpoint. These audits align with federal recommendations to enhance oversight, strengthen program integrity, and ensure the appropriate use of Medicaid funds.

During the audit, SGS will request medical records from network providers for a group of recipients selected through a statistically valid random sampling methodology. Providers are expected to submit all requested documentation promptly, accurately, and in full to support the review process.

Any questions should be directed to the contact information provided in the medical records request you receive from SGS.

Other Provider Announcements

The Tennessee Child and Adolescent Psychiatry Education and Support (TCAPES) Program at the Tennessee Department of Health, in collaboration with the Vanderbilt Kennedy Center’s Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), is offering a free, in-person comprehensive training on the identification and diagnosis of Autism Spectrum Disorder (ASD) for pediatric primary care providers.

What’s included?

  • Expert-led training on ASD diagnosis and best practices
  • A post-workshop Community of Practice for ongoing learning and peer connection
  • Dedicated office hours for personalized guidance and technical assistance
  • STAT kits provided at no cost to participants
  • CME credits available upon completion

Training Details: Registration is required!

Effective July 1, 2027, TennCare's timely filing limit for 1915(c) and ICF/IID claims will be reduced from one (1) year to one hundred twenty (120) days from the date of service.

Providers should ensure their billing processes and internal workflows are updated to meet this new requirement which will be effective for services provided on and after July 1, 2027. Claims submitted more than 120 days after the date of service will be denied for untimely filing.

TennCare will share additional guidance, including the link to the proposed rule change and updated policy language as soon as it is available. TennCare is working on finalizing updates to the current timely filing policy. Please note this still reflects a one-year timeline, but it may help answer any questions that arise related to dates of service.

TennCare will be reaching out individually to providers who regularly file claims 180+ days from the date of service to ensure they are aware of this change and working towards compliance effective July 1, 2027. In the meantime, providers can reach out if they have questions or need assistance preparing for this change.

Thank you for your continued partnership and commitment to serving TennCare members.

TennCare and the MCOs recently hosted a BESMART Education virtual webinar highlighting important updates to the BESMART program, along with pharmacy updates related to buprenorphine. The updated BESMART program description is available on TennCare’s Opioid Strategy webpage, and current information regarding buprenorphine can be found  on the Office-based Buprenorphine Treatment webpage.

If you would like to request a copy of the BESMART Education webinar recording, please contact Amber Huggins at amber_huggins@uhc.com. 

Health Plan and MCO Announcements

Review BlueCare Tennessee's BlueAlert Newsletter

Viewing our monthly newsletter is one of the best ways for BlueCare Tennessee network providers to stay up to date. Take a look at the July 2026 BlueAlert for these articles and much more:

  • Accurate Autism Diagnosis: What Providers Need to Know
  • New Guidance for Stand-Alone Vaccine Counseling
  • Call Us First: Guiding Patients to the Right Crisis Care 

New Dental Benefit - Renaissance

Annual Compliance, Cultural Competency and Fraud, Waste and Abuse Training

DUE Dec. 31, 2026

Keeping staff and patients safe is a top priority, and the Renaissance Compliance, Cultural Competency and Fraud, Waste and Abuse the trainings help ensure this by providing best practices for avoiding fraud, waste, and abuse at your practice.

All Renaissance participating staff and dentists must complete this training once each calendar year. Ensuring we comply with these standards allows us to operate better as a team and is mutually beneficial.

Follow the steps on the website to complete the annual training. Please note that your Renaissance participation agreement may be terminated if your business entity does not complete the required training.

UHCCP Preferred Lab Network

We’re excited to announce certain labs will continue to be a part of the Preferred Lab Network as of July 1. Referring patients to these labs may help reduce their out-of-pocket costs. Check out the Preferred Lab Network 

PCP Changes via Availity Essentials

As a reminder, Wellpoint providers should follow the PCP assignment change process through Availity Essentials, where member eligibility and provider acceptance criteria are reviewed before a change is completed. Please read the full article at the link below for important details about confirmation records, standardized PCP changes for minor children, required attestations, and the automatic distribution of new member ID cards after a PCP change.