Revalidations / How to Revalidate / Consequences for Not Revalidating

• How to revalidate

What are the consequences of failing to re-validate with TennCare?

• Termination of your Tennessee TennCare/Medicaid Provider Number will also terminate any contracts you currently hold with any of the Managed Care Organizations (Amerigroup, BlueCare, TennCare Select, UnitedHealthcare Community Plan, and the CoverKids program).
• Without an active Tennessee TennCare/Medicaid Provider Number you will not be eligible for any payments from Tennessee TennCare/Medicaid (crossover claims) and CoverKids or any of its contractors (MCOs, DBM, PBM).
• Without an active Tennessee TennCare/Medicaid Provider Number you will not be able to enter into any Single Case Agreements with an MCO or be paid as an out-of-network provider even with an out-ofnetwork authorization number from the MCO.
• Without an active Tennessee TennCare/Medicaid Provider Number you will not be able to access the TennCare Online Services web portal used by providers to verify TennCare enrollee eligibility.
• Without an active Tennessee TennCare/Medicaid Provider Number, any orders for tests or services, or medications prescribed by an individual provider for a TennCare enrollee or CoverKids will not be paid for by TennCare.
• Without an active Tennessee TennCare/Medicaid Provider Number, you will not be able to participate and receive an incentive payment through the TennCare EHR Provider Incentive Payment Program.
• There will be a break in your TennCare/Medicaid eligibility coverage should you re-validate after your TennCare/Medicaid ID has been terminated.