CHOICES Directory of Telephone Numbers, Addresses, Email, Web Contacts
Agency Name
Phone #
BlueCare Member Service Line
Bluecare Provider Service Line
TennCare Select Member Service Line
TennCare Select Provider Service Line
BlueCare Choices Long Term Care Provider
Service Line
Pharmacy SXC Health Solutions
Helpdesk
Pharmacy SXC Clinical PA Line
Explanation for Use
1-800-468-9698
Member questions to include BlueCare/TennCare Select, CHOICES &
Behavioral Health claims, billing, benefits & benefit limits. Excluding
Authorization Change Requests, Plan of Care changes, or Direct Questions for
CHOICES Care Coordinator
1-800-468-9736
Provider questions to include BlueCare/TennCare Select, CHOICES &
Behavioral Health Claims, Billing Guidelines, claim status, benefit limits, patient
liability. Excluding Authorization Correction Requests, Plan of Care Change
Request or Direct questions for CHOICES Care Coordinator
1-800-263-5479
Member questions to include questions to include BlueCare/TennCare Select,
CHOICES & Behavioral Health claims, billing, benefits & benefit limits.
Excluding Authorization Change Requests, Plan of Care changes, or Direct
Questions for CHOICES Care Coordinator
1-800-276-1978
Provider questions to include BlueCare/TennCare Select, CHOICES &
Behavioral Health Claims, Billing Guidelines, claim status, benefit limits, patient
liability. Excluding Authorization Correction Requests, Plan of Care Change
Request or Direct questions for CHOICES Care Coordinator
1-866-502-0056
Customer Service Representatives are set up to answer incoming questions fro
Long Term Care Providers related to eligibility, benefits, claims and billing
guidelines for BlueCare Choices.
Fax #
Website:
https://tnm.rxportal.sxc.com/rxclaim/portal/pre
Login
Pharmacy
Nurseline
Family Assistance Service Center (FASC)
1-866-434-5520
1-866-434-5524
Medication questions, RX authorization questions, Injection medications
Prior Authorization for Medications
1-800-262-2873
VSHP members may speak to a Registered Nurse (RN) anytime – 24-hours-aday, 7-days-a-week - with 24/7 Nurseline
English 1-866-311-4287
Applying for Tenncare, Report Change of Address, Phone #, Date of Death of
Spanish 1-866-311-4290 TTY Member, Request MCO Change Filing Appeal about getting or keeping
or TDD 1-800-772-7647
TennCare Letter of Creditable Coverage
Email or Web Address/Physical Address
1-866-434-5523
Premium Contact Information:
TennCare Premiums
P.O. Box 305133-37211
Nashville, TN 37211
615-253-7049
CHOICES Directory of Telephone Numbers, Addresses, Email, Web Contacts
Agency Name
Choices Direct Lines Rings to
Nashville/Green Hills Office
Phone #
Explanation for Use
Fax #
Email or Web Address/Physical Address
or IVR Options
BlueCare CHOICES Member Care Coordination
1-888-747-8955
Line
CHOICES Member Care Coordinators (HCCs) Coordinate ALL Medicaid
services for the elderly and disabled – physical, behavioral and long-term care.
Note: This line is also for general CHOICES Inquiries, authorization status,
authorization change requests and plan of care information for the BlueCare
CHOICES Member. All claim status & claim billing questions should go through
the BlueCare Member Service Line @ 1-800-468-9698 or BlueCare Provider
Service Line @ 1-800-468-9736
(615) 386-8589
providerauthissues_GM@bcbst.com
TennCare Select CHOICES Member Care
Coordination Line
Choices Member Care Coordinators (HCCs) Coordinates ALL Medicaid services
for the elderly and disabled – physical, behavioral and long-term care. Note:
This line is also for general CHOICES Inquiries, authorization status,
authorization change requests and plan of care information for the BlueCare
CHOICES Member.
(615) 386-8589
providerauthissues_GM@bcbst.com
1-800-782-2433
When a member and their caregivers have problems or complaints about care or
a service Provider they should report this to the assigned Care Coordinator at th
phone number or the member may also call the Tennessee Area Agency on
Aging and Disability Office (AAAD) at 1-866-836-6678 to register his or her
complaint. The member has 30 days after a denial is received to file an appeal.
Usually, the appeal is decided within 90 days after it is filed. If the member can’t
wait 90 days for health care or medicine and it is an emergency, the appeal can
be decided sooner—usually within 31 days (but sometimes up to 45 days). This
can be processed faster if the member has his or her doctor sign off on the
appeal statement before it is sent in.
CHOICES Member Complaint/Grievance1st
Step
CHOICES Member Complaint/Grievance2nd
Step if Step 1 doesn't resolve the issue call
(TennCare Solutions Unit)
1-800-782-2433 (Nashville
Office)
1-800-878-3792
The member or caregiver can contact the TennCare Solutions Unit if their issue
is not resolved by the Care Coordinator during the first step or the complaint is
against the Care Coordinator, and the Care Coordinator's Supervisor or Manager
is not able to rectify the issue by assigning another Care Coordinator. Note:
The member has 30 days after a denial is received to file an appeal. Usually, the
appeal is decided within 90 days after it is filed. If the member can’t wait 90 days
for health care or medicine and it is an emergency, the appeal can be decided
sooner—usually within 31 days (but sometimes up to 45 days). This can be
processed faster if the member has his or her doctor sign off on the appeal
statement before it is sent in.
CHOICES Directory of Telephone Numbers, Addresses, Email, Web Contacts
Agency Name
CHOICES Member Complaints, Grievance
Phone #
1-800-468-9698
Explanation for Use
Fax #
(615) 386-8589
1-888-747-8955
Critical Incidents should be reported immediately to the Care Coordination Line.
Critical Incidents include but are not limited to the following: Unexpected death
of CHOICES member, suspected mental or physical abuse, theft for financial
exploitation, severe injury, medication error, sexual abuse or suspected sexual
abuse, abuse and neglect, or suspected abuse and neglect.
Abuse & Neglect Cases for Adults
1-888-277-8366
Suspected abuse, neglect and exploitation of members who are adults must be
immediately reported to the Care Coordination Line with 24 hours of the incident,
as well as to this number
Abuse & Neglect Cases for Children
1-877-237-0004 or
1-877-542-2873
Suspected abuse, neglect and exploitation of members who are adults must be
immediately reported to the Care Coordination Line with 24 hours of the incident
as well as one of these contacts
Critical Incident Reporting Process
Phone #
For people who do not already have Medicaid, this is the number they may call to
speak with someone who can tell them more about CHOICES. Note: If the
caller is not already enrolled with current TennCare benefits, he or she will have
to go through the application process to see if benefits can be approved.
Area Agencies on Aging and Disability
Area Agencies on Aging and Disability
(AAAD)/Single Point of Entry (SPOE)
1-866-836-6678
This number rings to a AAAD in the member's region
Aging Commission of the Mid-South
(901) 324-6333
AAAD contact for Memphis, TN
(901) 327-7755
First TN Dev. District
(423) 928-0224
AAAD contact for Johnson City, TN
(423) 928-5209
East TN Human Resource Agency
(865) 691-2551 ext. 216
AAAD contact for Knoxville, TN
(865) 531-7216
Southeast TN Dev. District
(423) 266-5781
AAAD contact for Chattanooga, TN
(423) 424-4225
Upper Cumberland Dev. Distric
(931) 432-4111
AAAD contact for Cookeville, TN
(931) 432-6010
Greater Nashville Regional Counc
(615) 862-8828
AAAD contact for Nashville, TN
(615) 862-8840
South Central TN Dev. District
(931) 381-2040
AAAD contact for Columbia, TN
(931) 381-2053
Northwest Dev. District
(731) 587-4213
AAAD contact for Martin, TN
(731) 588-5833
Southwest TN Dev. District
(731) 668-7112
AAAD contact for Jackson, TN
(731) 668-6438
Email or Web Address/Physical Address
CHOICES Directory of Telephone Numbers, Addresses, Email, Web Contacts
Agency Name
1-800-357-0395
Explanation for Use
Question applications or to check status of credentialing, add a new office
location to their contract
Provider Network Service Department
1-800-924-7141
If an in-state provider is inquiring about the status of a recently submitted
BlueCare/TennCareSelect contract, they should be referred to the Provider
Network Service Department .
Buffy Bass-Douglas
Nathan Key
Sheldon House
(423) 535-3856
(615) 760-8707
(901) 544-2170
CHOICES Network Representative for East Grand Region
CHOICES Network Representative for Middle Grand Region
CHOICES Network Representative for West Grand Region
Credentialing Contact Information
Phone #
Dial-Up Modem
Hyper Terminal Connection
Email or Web Address/Physical Address
Buffy_Bass_Douglas@bcbst.com
Nathan_Key@bcbst.com
Sheldon_House@bcbst.com
Electronic Visit Verification System is required to be used for CHOICES Home
and Community Based Service Provider Billing for Adult Day Care, Attendant
Care, Companion Care, Home Delivered Meals, Home Maker Services, In-Home
Respite and Personal Care
Electronic Visit Verification System (EVV)
Sandata
Fax #
1-877-526-0516
Provides technical support for HCBS providers. When providers use the EVV
System, all claims will transmit to Sandata via the EVV System. Once claim
information is collected from providers, Sandata will submit all EVV providers’
claims to VSHP via the secure File Transfer Protocol (FTP) connection. Note:
Providers will need a dial-up modem and or hyper terminal connection if they
would like to receive Proof of Timely Filing and Reject Reason Reports. Note: If
a claim is rejected due to an error on the provider or Sandata's part, the provider
will need to obtain the explanation from the E-business Service Center and call
Sandata to have the problem with the claim corrected and then Sandata will have
to resubmit the claim.
(423) 535-5717
Providers will need a dial-up modem and if they would like to receive Proof of
Timely Filing and Reject Reason Reports. The phone line does not have to be a
dedicated line.
www.bcbst.com/providers/ecomm/technicalinformation.shtml
(423) 535-5717
Providers will need a dial-up modem and or hyper terminal connection if they
would like to receive Proof of Timely Filing and Reject Reason Reports
HyperTerminal is a tool that lets you connect to other computers, Internet telnet
sites, bulletin board services, online services, and host computers, using either
your modem or a null modem cable.
Email: ecomm_techsupport@bcbst.com
CHOICES Directory of Telephone Numbers, Addresses, Email, Web Contacts
Agency Name
Phone #
Explanation for Use
Fax #
Email or Web Address/Physical Address
1-800-924-7141
E-Business Solutions can assist providers with electronic claims issues to
confirm if electronic claims transmission is completed correctly, resolve issues
with the claims transmission and provide claims number and explanation for
rejected claims. E-Business Solutions also works with the Web Portal
Email: ecomm_contracts@bcbst.com or
Configurations Email:
ecomm_sysconfig@bcbst.com Web:
www.bcbst.com/providers/ecomm/
1-800-924-7141
E-Business Solutions can handle the contracting for providers who want to be
set up to file claims electronically. They can answer enrollment status questions
for the electronic process, as well as answer claim submission questions.
Email: ecomm_contracts@bcbst.com or
Configurations Email:
ecomm_sysconfig@bcbst.com
BlueAccess
Providers may register for BlueAccess on the BCBST website. BlueAccess
enables providers to view information in a secure, online environment, just as it
appears right now in the customer service computer system, along with viewing
remittance advices.
Web: www.bcbst.com
Electronic Clearing House
The method for HCBS providers to use an Electronic Clearing House to file
claims for the following services: Assisted Care Living Facilities, Assistive
Technology, Critical Adult Care Homes, Minor Home Modification, Nursing
Facilities, Person Emergency Response Systems (PERS), and Pest Control
E-Business Solutions
Provider Contracting
Paper Claims
BlueCare Claims Service Center can be used to submit paper claims
Provider Administration Manuals
These manuals contain the provider contracting information for CHOICES
Providers along with specific billing guidelines
BlueCare Claims Service Center
1 Cameron Hill Cr, Ste 0002, Chattanooga,
TN 37402-0002
Web: www.vshptn.com or www.bcbst.com