Provider Resources

This quick and easy to follow reference guide provides a road map for individual providers to follow when going through their TennCare Registration.

Keep Your Information Up To Date

Failure to keep your data, including email addresses up to date, may cause the termination of your Medicaid ID along with all Managed Care Contracts.

1. For Individual providers, CAQH ProView eliminates duplicative entry with organizations that require your professional and practice information. There are also required updates for revalidating that providers must complete in CAQH including updating licenses, practice location change or addition and credentialing information.
2. For Groups, Organizations and Entities, utilize the PDMS User Log In (Provider Portal) to maintain your information.
3. Important TennCare Reminders

TennCare Newsletters

1. Provider Insider Newsletters from Provider Experience
2. Long-Term Services and Support (LTSS) newsletter
3. TennCare Pharmacy Updates
4. Division of TennCare Eligibility Newsletter

Ensure your email address is up to date with TennCare so you can receive these important monthly newsletters! These links are updated monthly, so check back for frequent updates!

Managed Care Contractors (MCC) Links

1. BlueCare - Health Care Providers
2. United Health Care - UnitedHealthcare Community Plan of Tennessee Homepage
3. Wellpoint – Provider News
4. DentaQuest – TN Provider Page

Helpful Links

Claims Appeals & Provider Complaints - Follow this link for claims disagreements, if you need to file an appeal, have issues with appeal outcomes or other information regarding claims, appeals or complaints. Claims, Appeals & Provider Complaints (tn.gov)

Verify member eligibility - Providers can verify patient eligibility here - TennCare Online Services (tn.gov)

If you ever have any questions, or concerns or need guidance please contact the TennCare call center, at 1-800-852-2683