BlueCare Tennessee CHOICES Provider Training 2014

Transcription

1 BlueCare Tennessee CHOICES Provider Training

2 Agenda CHOICES Program CHOICES 101 Credentialing Process & Site Visits Contractual Agreements Contract & Guidelines CHOICES Process & Procedures Member Eligibility and Authorization Process Electronic Visit Verification (EVV) & Claims Information Claims Processing Critical Incident & Reporting Helpful Resources 2

3 CHOICES 101 Buffy Bass-Douglas 3

4 CHOICES 101 The Long-Term Care Community CHOICES Act of 2008 restructured Medicaid s long-term care system Members 65 years and older; or Over the age of 21 with a physical disability Members require care in a Nursing Facility or in a Home and Community-Based Setting Referrals from physicians or family members made through one of nine Area Agency on Aging and Disability Agencies Once enrolled, medical and financial eligibility criteria must be met on ongoing basis 4

5 CHOICES 101 Eligibility Criteria Three types of groups (categories) based on member s medical status Group 1: Meets Nursing Facility Level of Care; lives in a nursing facility; annual cost cap of $57,300; only receives nursing facility care. Group 2: Meets Nursing Facility Level of Care; lives in the community; annual cost of care does not exceed the cost of a nursing facility; no entitlement to the $57,300 annual cost cap; individual receives all Home and Community-Based Services (HCBS). Group 3: Does not meet nursing facility level of care, but the member is at risk of nursing facility placement without HCBS; lives in the community; annual cost cap of $15,000. Bureau of TennCare determines the member s group 5

6 CHOICES 101 Roles and Responsibilities Care Coordinator Registered Nurse or Master s Level Social Worker responsible for performing face-to-face assessments and creating the person-centered plan of care. Primary contact for member s care coordination. Member Associate Responsible for contacting providers per the plan of care, validating the plan of care services per member s benefit plan, initiating services, authorizing ongoing services, and ending services based on member s eligibility. Provider Network Manager Primary contact for providers and responsible for conducting site visits, training and education; Manage credentialing and recredentialing requirements. Provider Inquiry Specialist Dedicated resources who provide technical expertise through data research and resolution for complex provider inquiry issues; Responsible for maintaining integrity for the Electronic Verification System (EVV). 6

7 CHOICES 101 Developing Plan of Care Needs Assessment Care Coordinator Planning Stage Family Involvement Plan of Care Person-centered Includes longterm care services/support 7

8 CHOICES 101 Level of Care Requirements The member s Level of Care must be reassessed at least annually. The member must be reassessed within five (5) business days of becoming aware of any change that could affect the Level of Care eligibility. Members must continue to meet the level of care criteria for the CHOICES group in which they are enrolled. Throughout this process, the Care Coordinator will: Communicate eligibility end dates to members. Educate members on importance of maintaining CHOICES eligibility. Educate members that eligibility is redetermined on an annual basis. Inform group 2 and 3 members that TennCare may assist with redetermination when a member is at risk of losing eligibility. 8

9 CHOICES 101 Assigning Providers The Member Associate creates authorizations based on Provider availability and ability to provide the services as described. The Associate first contacts Providers listed on the member s Provider Selection List. As needed, additional providers will be contacted in order to initiate the plan of care within the required timeframes: 10-day services Assisted Care Living Facility, Adult Day Care, Attendant Care, Home Delivered Meals, Personal Care, Personal Emergency Response System. 30/60/90-day services Assistive Technology/Pest Control/Minor Home Modification. Members are able to terminate, reduce, place holds, resume services, and change Providers or Groups, resulting in changes to their services. The Associate is responsible for updating authorizations when these events occur. 9

10 CHOICES 101 Authorization Requirements The following covered services require authorizations: Personal care visits (T1019) Short visits to help the member get out of bed, bathe, dress, make meals, use the bathroom, and help with chores or errands. Limited to two (2) visits a day, where the visit lasts less than 4 hours. Visits must be more than 4 hours apart. Attendant care (S5125) Just like personal care visits, but visits are longer than 4 hours and 15 minutes, or shorter visits that are less than 4 hours apart. Home-delivered meals (S5170) One meal per day delivered to the member s home. The options are fresh or frozen meals, depending on the member s request. 10

11 CHOICES 101 Authorization Requirements Personal Emergency Response System (S5160 & S5161) A call button so the member can get help in an emergency; available 24 hours a day. Adult day care (S5100) A place that provides supervised care and activities during the day; up to 2,080 hours a year. In-home respite care (S5150) Someone to stay with the member in their home for a short time so their natural caregiver can get some rest; up to 216 hours a year. In-patient respite care (S5151) A short stay in a nursing home or assisted care living facility so the natural caregiver can get some rest; up to 9 days a year. 11

12 CHOICES 101 Authorization Requirements Assistive technology (T2029) Certain low-cost items that help the member do things more easily or safely in their home, like grabbers to reach things. Pest control (S5121) Spraying the inside and/or the outside of member s home for bugs or mice; up to 9 sprays per year, averaging to approximately 1 spray every 6 weeks. Documentation, including the member s signature or member s representative signature, is required to validate services occurred. Minor home modifications (S5165) Changes to a member s home that will help them get around more easily and safely, like grab bars or a wheelchair ramp. 12

13 CHOICES 101 Authorization Requirements Assisted Care Living Facility (ACLF) (T2030/T2031) A place the member lives that helps with personal care needs, homemaker services, and taking their medication. The member must pay for their room and board. If a member leaves the ACLF, contact BlueCare Tennessee to avoid claims payment issues. Critical Adult Care Home (CACH) (T2032/T2033) A home where the member and no more than four (4) other people live with a health care professional that takes care of special health and long-term care needs. The CHOICES member must pay for their room and board. Under state law, CACH is available only for people who are ventilator-dependent or who have traumatic brain injury. 13

14 CHOICES 101 In-Home Respite What is In-Home Respite? Available for both Group 2 and 3 members; must be included on an approved Plan of Care Provided on a short term basis in the member s home Offered in the absence of the natural caregiver who normally provides care for the member Offered for the relief of the natural caregiver who normally provides care for the member What can t be covered under In-Home Respite? In-Home Respite cannot be used to take the member out of their home, i.e. for a doctor s appointment or dialysis visit Cannot be used to add more Personal Care or Attendant Care services 14

15 CHOICES 101 In-Home Respite How should In-Home Respite be requested? The Member (or member representative) may send requests for In-Home Respite to the Support Center at , option 1 (or phone number located on the back of their BlueCare Tennessee ID card). It is strongly recommended providers do not make requests for in-home respite. In-Home Respite must be approved prior to providing the service to the member. Approval is not guaranteed. The Support Center will verify with the member that In-Home Respite has been requested and that it is needed for a covered reason. Things to keep in mind: If a member has In-Home Respite available, they only have 216 hours for the entire calendar year. This benefit should be used on an as-needed basis only. The member is not penalized for not using in-home Respite; it is not a use it or lose it benefit. 15

16 CCHOICES Provider Credentialing Process & Site Visits Phyllis White 16

17 CHOICES Credentialing Process Credentialing occurs during the application process for any Provider applying to participate in the CHOICES network. After the enrollment application is completed, and the Contract agreement is signed, a site visit will be conducted for all initial applicants. After a Provider is approved and enrolled in the CHOICES network, recredentialing occurs annually (or based on the service type) during the yearly site visits. The CHOICES credentialing process adheres to the NCQA Standards and Guidelines to ensure that contracted Providers meet the applicable State requirements. 17

18 CHOICES Credentialing Process Credentialing and/or re-credentialing standards meet TennCare State rules, Contractor Risk Agreements, and Accreditation of Managed Care guidelines with such processes as noted below: Licensure and/or certification Exclusion and/or debarment monitoring NPI and Medicaid Number verification General and Professional insurance liability validation with acceptable limits Ownership Disclosure forms Proof of recent acceptable inspection results Completed Credentialing Application Documentation from a successful Site Visit 18

19 CHOICES Credentialing Site Visit The regionally assigned Provider Network Manager will contact Providers to schedule an appointment for initial or annual site visits to complete credentialing or re-credentialing requirements. Initial/Re-credentialing application Copy of Current License Copy of Liability Insurance & Complete Site Assessment Deficit Reduction Act Training (Section VII Provider Administration Manual) Compliant with required Policies and Procedures Background Checks, Staff Records and Training Requirements Critical Incident Report/Management 19

20 CCHOICES Provider Contract & Guidelines Jeff West 20

21 CHOICES Provider Contract & Guidelines Each Provider agency must sign the TennCare Provider Agreement and a properly executed copy must be on file with the TennCare Provider Relations Department. Providers shall cooperate fully with BlueCare Tennessee CHOICES in the completion and execution of the Plan of Care services documented for each member. Provider s reimbursement shall be contingent upon the provision of services to an eligible member in accordance with applicable federal and state requirements. 21

22 CHOICES Provider Contract & Guidelines Provider Agreement Responsibilities HCBS Provider Agreement Contractor Risk Agreement ( Provider Administration Manual ( Newsletters.html) TennCare Rules & Regulations ( Termination of Services to a member As soon as possible but at least thirty (30) days advance notice Termination of a Contracted Service As soon as possible, but at least sixty (60) days advance notice Written notification must be submitted to include The reason for the decision and To collaborate to transition members to alternate Providers 22

23 CHOICES Provider Contract & Guidelines It is important to note that Providers cannot: Require a member to choose their agency as a Provider of multiple services as a condition of providing any service to the member; Solicit members to receive services from their agency, including: Referring an individual for CHOICES screening with the expectation that the Provider will be selected by the member. Petitioning the member to change CHOICES Providers. Communicate with hospitals, discharge planners or other institutions for the purposes of soliciting potential CHOICES members that should instead be referred to the person s Managed Care Organization or Area Agency on Aging and Disability. 23

24 CHOICES Provider Contract & Guidelines Things to remember: The official CHOICES brochures or other CHOICES materials cannot be altered in any manner. The CHOICES logo may not be reproduced. Providers may not conduct any marketing activities that could be considered direct solicitation of potential CHOICES members such as repeated face-to-face visits, telephone outreach, or continued recruitment after an offer for enrollment is declined. Offers of gifts, material or financial gain as incentives to enroll is strictly prohibited. 24

25 CHOICES Provider Contract & Guidelines Things to remember: A Disclosure Form is required for the Bureau of TennCare to monitor payment of Medicaid funds to Providers. BlueCare Tennessee is required to have this form on file for all Providers receiving Medicaid funds. These forms will be requested upon enrollment in the program and upon any changes while contracted in the CHOICES program. Failure to comply will result in non-payment of claims. To ensure you have a Disclosure of Ownership on file, please call to confirm. Disclosure forms can be found at the following link: 25

26 CHOICES Provider Contract & Guidelines Loans, Gifts, or Favors It is never acceptable for a worker to ask for or accept loans, gifts or favors of any type. These situations present a potential conflict of interest and may terminate the worker s ability to serve BlueCare Tennessee CHOICES members. Provide ongoing training and reminders to workers about never requesting or accepting loans, gifts or favors in order to prevent situations which may be interpreted as financial exploitation or theft. 26

27 CHOICES Provider Contract & Guidelines While serving CHOICES members, please contact your Provider Network Manager or BlueCare Tennessee at with any changes to your Provider status, or with updates to services and data. Changes may include: Address, and/or changes to phone and fax numbers. Changes to current services offered to CHOICES members, adding new services, or discontinuation of a current service. Changes to Provider payment information. Questions about the Provider contract or the services provided to CHOICES members in accordance to the Plan of Care. 27

28 CHOICES Provider Contract & Guidelines Background Checks Background checks must be performed on workers who provide direct care to members. Providers must have policies and procedures in place for the review of background checks. These policies and procedures must have a mechanism in place for applicants to submit an exception request if employment is denied as a result of the background check. The policy must also include a mechanism for the review of those exception requests with feedback to the applicant on the agency s final decision. 28

29 CHOICES Provider Contract & Guidelines Monthly background checks must be completed using the website located at the Office of Inspector General (OIG). All employees must receive a background check prior to the first day of employment. Copies of all background checks must be printed and kept in the employee s personnel file. 29

30 CHOICES Provider Contract & Guidelines OIG Fraud Prevention & Detection Search on LEIE Exclusions (monthly) TN Abuse Registry (annually) TN Sexual Offender Registry (annually) National Sexual Offender Registry (annually) TN Felony Offender Registry (annually) TN Out of State Probation & Parole Registry (annually) Criminal Background Check 30

31 CHOICES Procedures Member Eligibility Authorization Process Vinny Cardi 31

32 CHOICES Member Eligibility Must be current CHOICES member enrolled in groups 1, 2, or 3 and have authorization for community-based services for dates of services authorized. Member eligibility directly impacts the approval of claims processing. Options for eligibility validation is as follows: EVV shows a member s eligibility under the Payor Information section: 32

33 CHOICES Member Eligibility Providers may validate member eligibility using Tennessee Online Services, the State of Tennessee s eligibility website: Providers may also contact BlueCare Tennessee Eligibility/Provider Service Line:

34 CHOICES Care Plans/Provider Plan of Care The Plan of Care is developed by the Care Coordinator taking in consideration of needs identified during an assessment, the care plan to address those needs, the facilitation of the plans and the advocacy of the member. Care Coordinators will be engaged with groups 1, 2, and 3 in developing the most effective plans for members. The amount, frequency, duration and scope will be fully documented in the Plan of Care. A copy of the Plan of Care will be provided to the member, the member s representative and any residential alternative Provider, as applicable. The Provider Plan of Care (PPOC) will be provided to authorized Providers. Only authorized services should be provided to members. 34

35 CHOICES Authorizations and Services Providers should only provide services according to the authorization as it appears in the Electronic Visit Verification database (EVV) and as it appears on the Provider Plan of Care (PPOC). If a service is scheduled for four (4) hours, the caregiver should not stay beyond this timeframe. Providers will not receive reimbursement for additional service hours that are not authorized. 35

36 CHOICES Authorizations and Services Providers should call the Support Center at , option 1 when: The services listed on the Provider Plan of care are different than the services initially discussed with the CHOICES Support Center. The Provider Plan of Care is unclear or difficult to read. A Provider has questions about the services contracted to provide. The authorization for a service is at risk of ending. 36

37 CHOICES Authorizations and Services Member status changes will impact authorizations and how a Provider offers services such as: Hospitalizations Vacations Holidays Nursing Facility stays Hold/Resume services When services are placed on hold, Providers will receive an Authorization Confirmation form that contains service details, changes and continuation information. Discontinuing services If a service needs to be discontinued, Providers will receive an Authorization Confirmation form that contains details about when to stop providing services. 37

38 CHOICES Member Status Changes When Providers identify a change in a member s status, please contact BlueCare Tennessee: Provider shall contact BlueCare Tennessee immediately if a member s status changes by calling , option 1. Examples include: A member is admitted to the hospital A Provider is unable to reach a member Any time members have changes in demographics (i.e. address, phone, etc.), this must be reported to Tennessee Health Connection (TNHC). Members can contact TNHC using the following information: Toll Free: Fax: Mail: P.O. Box Nashville, TN

39 CHOICES Member Schedule Changes How Are One-Time Schedule Changes Requested? Providers cannot make requests for one-time schedule changes. The Member must make the request for a one-time schedule change. The Member can make that request by calling , option 1. An approval or denial for the one-time schedule change will be granted by the BlueCare Tennessee Support Center Management. The Support Center staff member will revise the authorizations and notify all parties via and/or phone that the One-Time Schedule Change is either approved or denied. 39

40 CHOICES Member Complaints A member complaint is anything that causes the member dissatisfaction with their health plan, servicing Provider, employees or staff. Examples: Members have not received services as contracted such as obtaining pest control, delivered meals, or any other service that is included in the Plan of Care that is untimely, or unsatisfactory service. Members experience dissatisfaction with the servicing Provider due to the caretaker being consistently late, unreliable or not dependable. The services and duties performed are not in accordance to the contract. BlueCare Tennessee is contractually obligated to report all complaints to the Bureau of TennCare. Providers shall direct members to contact BlueCare Tennessee to report a complaint. 40

41 CHOICES Electronic Visit Verification (EVV) & Claims Information Ebony Williams 41

42 CHOICES Electronic Visit Verification (EVV) The EVV System is an electronic system Provider staff and consumer-directed workers use to record visits with members. Users check-in and out at the beginning and end of each service delivered to monitor member receipt of HCBS. EVV also used for submission of claims. EVV/Sandata Technologies Adult Day Care Attendant Care Companion Care Home Delivered Meals In-Home Respite Personal Care 42

43 CHOICES Electronic Visit Verification (EVV) EVV Compliance Failure to comply with BlueCare Tennessee s expectations on the appropriate utilization of EVV may result in disciplinary actions up to potential termination from BlueCare Tennessee s network. Every Provider must have at least one dedicated employee for EVV monitoring and at least two employees trained on EVV. 43

44 CHOICES Electronic Visit Verification (EVV) EVV training resources can be found in the Sandata library at Username: nhtraintn Password: 3stars Helpful items in the library: Log In Instructions Calling in for Multiple Clients in the Same Home Exception Handling Guide TennCare Billing Guidelines Scheduling Overview BlueCare Tennessee requires that you: Have two (2) staff trained in EVV at all times Include signed training attestations in staff files Work missed/late visit report Know who to contact Adhere to timeframes for working exception reports * You must have a current address on file with Sandata at all times. * You must submit claims with the appropriate Provider ID/NPI # for the service rendered. 44

45 CHOICES EVV Missed/Late Visit Process Notify BlueCare Tennessee immediately with any change to authorized services: or Report missed/late visit after normal business hours: All visits/services must be scheduled in EVV before providing services Visits should never be cancelled BlueCare Tennessee must be notified immediately any time scheduled services are not going to be provided to a CHOICES member. The Provider must have backup options Ensure the backup staff meets the qualifications for the Covered Service Ensure sufficient staff exists to provide services per the Provider Plan Of Care Ensure adequate backup staff exists in the event that the originally scheduled worker cannot provide services per the Plan Of Care 45

46 CHOICES EVV Missed/Late Visit Process Missed visits increase Provider liability; An explanation must be provided in EVV if a visit does not occur Provide an accurate reason and resolution status 46

47 CHOICES Claims Submissions/Non-EVV Providers who can t submit claims for reimbursement through the EVV database must do so through the CHOICES Web Portal or an approved Third Party Electronic Vendor. First, complete online registration through BlueAccess at: Web Portal & Electronic (Blue Access) Assisted Care Living Facility Services Assistive Technology Critical Adult Care Home Minor Home Modifications Nursing Facility Services Personal Emergency Response System (PERS) Pest Control Questions about the Web Portal or registration? Call Questions about a claim? Call

48 CHOICES Claims Submissions/Non-EVV The following items must be submitted on CHOICES Nursing Facility claims: Admission/Start-of-Care date (Field Locator 12 of the UB) is required. This date is specific to this episode of care. Occurrence Code 54 and the corresponding last date of a physician follow-up visit is required on all ICF and SNF claims. Occurrence Code 55 and the corresponding Date of Death is required on all claims submitted with Discharge Status 20, 40, 41 or 42. This will be in addition to Occurrence Code 54. A valid Attending Provider NPI is required on all ICF and SNF claims. 48

49 CHOICES Claims Submissions/Non-EVV The following items must be submitted on CHOICES Home and Community-Based Services: Admission / Start-of-Care date (Field Locator 12) is required. This date is specific to this episode of care. Type of Admission (Field Locator 14) is required. This code indicates the priority of this admission. Point of Origin for Admission or Visit (Field Locator 15) is required. Occurrence Code 55 and the corresponding Date of Death is required on all claims submitted with Discharge Status 20, 40, 41 or 42. Attending Provider (Field Locator 76, 1 & 2) is required on all CHOICES claims 49

50 CHOICES Claims Submissions & Timely Filing CHOICES Claims received 08/01/2011 and After: Claims must be submitted within 120 days from the date of service or within 60 days of the original BlueCare Tennessee rejection notice date. Members cannot be billed when a claim has received a timely filing denial. The Provider can request for a review of the denial. CHOICES Retro Eligibility Timely filing for CHOICES claims is 120 days from the date of service or the add-date of CHOICES coverage. Corrected Claim Timely Filing Timely filing for corrected bills is 120 days from the remit date of a claim. 50

51 CHOICES Claims Submissions & Rejected Claims If you have filed a claim that BlueCare Tennessee rejects, you may wish to submit a corrected claim. For guidance on how to file an electronic claim, please contact e- Business at Following are links for rejection code explanations: Institutional Edit: tutionaledits.pdf Professional Edit: essionaledits.pdf Supplemental Edit: mental_bluecaretenncareselect_edits.pdf 51

52 CHOICES Claims Submissions & Appeals Appeals Provider Dispute Resolution Process Provider Dispute Resolution Form The Provider Dispute Resolution Form is available in the BlueCare Tennessee Provider Administration Manual and via the bcbst.com website. The dispute submission should include prior correspondence, applicable medical records, and a detailed explanation for the dispute. Insufficient Documentation The Provider Appeals area will notify the Provider that additional information is needed; the file will be closed pending receipt of the required information. The Provider must include any pertinent information for consideration; details may be found in the CHOICES Claims Reference Guide. 52

53 CHOICES Claims Submissions & Appeals Response Time Frame Our goal is to resolve disputes within 60 days of receipt. If a dispute hasn t been resolved within 60 days, we will provide status updates to the Provider every 30 days. Providers can request status updates from the Provider Appeals department. Note: There is not an expedited appeal process for Level 2 appeals. Expedited appeals are only available through the Utilization Management areas for adverse decisions regarding Medical Necessity. Provider Appeals Address BlueCare/TennCareSelect Appeals 1 Cameron Hill Circle, Suite 0039 Chattanooga, TN Fax:

54 Critical Incident & Reporting Vinny Cardi 54

55 CHOICES Critical Incident Definition A Critical Incident has to meet all of the following criteria: 1. Did the incident happen in a Home and Community-Based Setting (HCBS)? 2. Did the incident happen to a CHOICES member? 3. Did the incident occur within the provision of a covered HCBS? 4. Is the incident a Critical Incident type: Abuse Physical, sexual or mental Neglect Financial Exploitation including cash, debit cards, government check, food stamp card Theft including medication theft, possessions, valuables, credit cards Medication Error Unexpected Death Severe Injury (treat as a critical incident if you cannot rule this out) If the answer to all four (4) questions is yes, report to BlueCare Tennessee within 24 hours of discovery and remove the worker from his/her duties for all TennCare members until the Critical Incident investigation is completed.

56 CHOICES Critical Incident - Timeframes Date of discovery: The date and time the Provider discovers the critical incident Initial report: Due to BlueCare Tennessee from the Provider within 24 hours of the date of discovery APS notification: Due to APS from the Provider within 24 hours of the date of discovery, if applicable Initial written report: Due to BlueCare Tennessee from the Provider within 48 hours of the discovery Follow-up report: Report of the investigation due to BlueCare Tennessee from the Provider within 20 days of the date of discovery 56

57 CHOICES Critical Incident - Guidelines Immediate actions: Contact Emergency Medical services or Law enforcement as needed; Remove the HCBS worker immediately and for the duration of the investigation; Ensure services continue with a replacement worker or the member s back-up plan; Incident form: Complete the Critical Incident Form Perform and document all immediate actions; Submit the form and any supporting documents to BlueCare Tennessee at CHOICES_Quality_GM@bcbst.com. Non-critical incidents: If the incident does not meet the requirements of a Critical Incident, do not submit the incident form to BlueCare Tennessee. Feedback form: The BlueCare Tennessee Quality department will send feedback forms to Providers to allow for quality review. 57

58 Adult Protective Services There are times when Providers will need to contact Adult Protective Services (APS). Circumstances can occur when reporting a Critical Incident or even if an event is not a Critical Incident. APS contact is required by the law within twenty-four (24) hours of the discovery of any of the following situations: Physical abuse Sexual abuse Emotional abuse Financial exploitation Neglect by others Adult Protective Services Fax number

59 Helpful Resources 59

60 Contact Information Department CHOICES Customer Service (CHOICES Customer Service/Claims Issues) Phone Number ebusiness Sandata Technologies Provider Inquiry Specialists for EVV missed or last visits Useful Links BlueCross BlueShield of Tennessee BlueAlert Newsletters BlueCare Tennessee Provider Administration Manual BlueCare Tennessee BlueCare CHOICES Web Portal Blue Care CHOICES Critical Incident Form CHOICES Newsletters CHOICES Critical Incidents Training ebusiness Tools and Resources b_portal_tutorial.pdf dentform.pdf Training.pdf 60

61 Quick Reference BlueCare Tennessee Phone Numbers : BlueCare Tennessee, Provider Network Managers, Disclosure of Ownership verification : BlueCare Tennessee Eligibility/Provider Service Line, Claims, Member Complaints (423) , option 2: Web Portal , option 1: BlueCare Tennessee Provider Inquiry, Support Center , option 1: Support Center : Missed/late visit (after normal business hours) BlueCare Tennessee Fax Numbers : Eligibility Form fax number External Contact Information Adult Protective Services: , fax number: Tennessee Health Connection: , fax number: , mail: P.O. Box , Nashville, TN

62 Provider Network Managers CONTACT INFORMATION: Bianca Merrell East Region (423) Jeff West Middle Region (615) Vincent Cardi Middle Region (615) Ebony Williams West Region (901) Obion Weakley Henry Dyer Gibson Carroll Henderson Madison Haywood Tipton Chester Stewart Montgomery Robertson Houston Dickson Davidson Humphreys Williamson Hickman Perry Maury Lewis Macon Clay Sumner Trousdale Jackson Fentress Overton Smith Wilson Putnam DeKalb Cumberland White Rutherford Warren Rhea Bedford Coffee Grundy Scott Morgan Roane McMinn Campbell Anderson Loudon Monroe Blount Union Knox Claiborne Sevier Hamblen Jefferson Cocke Hawkins Greene Sullivan Washington Carter Johnson Shelby Fayette Hardeman McNairy Hardin Wayne Lawrence Giles Lincoln Franklin Marion Hamilton Bradley Polk 62