• Who are you?
• How can you help?
  We can help you navigate the TennCare system, and can work with our contacts at the TennCare Bureau and the Department of Human Services to make sure you're getting the services you need. If you are a TennCare enrollee, or believe you are eligible for TennCare, and you need help getting enrolled, getting a doctor's appointment, getting a prescription filled, or otherwise getting necessary medical care, we can help. Family members or friends of TennCare enrollees can call us if the enrollee wants you to be the one to talk with us. We can help service providers (like Doctor’s offices, pharmacists, Social Workers) who are helping their clients. We can help you by:
  • Accessing state data systems
  • Using our expertise in finding data errors that affects care and coverage
  • Using our bilingual counselors who speak Spanish, Kurdish, Arabic, Somali, Vietnamese
  • Navigating the complicated TennCare, Safety Net, Medicare, Social Security and Medicaid systems for our callers
  • Monitoring cases and following through to callers

• When can I call?
• Do you have a toll-free number?
• How are you funded?
• Do you have services in other languages?
• Can I apply for TennCare with you?
• Can you get me my medicine?
• Are you TennCare?
• Do you share my information with other groups?
• Why do you want my social security number?

• I just received a bill, do I need to pay it?
• I have TennCare, but TennCare won't pay for my treatment. What can I do?
• What happens if my health plan denies a claim and the provider starts billing me?
• I have TennCare but I can’t get my medicine. What can I do?
• I called my health plan to find a doctor, but they don't have any close to me. What can I do?
• I lost my TennCare card. What can I do?
• I can't drive myself to the Doctor. What can I do?
• My income/family information or my address has changed, what do I need to do?
• I am very sick but my DHS worker says I don't qualify for TennCare. What can I do?
• I've lost my TennCare? What can I do?

• What is TennCare?
• What is the difference between TennCare and Medicaid?
• How do I qualify for TennCare?
• How do I apply?
• Where do I go to get an application?
• I have other insurance, can I get TennCare?
• I'm eligible for a HIPAA plan, can I get TennCare?
• I'm eligible for COBRA can I get TennCare?
• I have SSI, can I get TennCare?
• I have Medicare, can I get TennCare?
• I have a card, is my TennCare OK?
• Do I have TennCare Standard or TennCare Medicaid?
• What is the difference between TennCare Standard and TennCare Medicaid?

• What health services does TennCare offer?
• What dental services does TennCare offer?
• What mental health services does TennCare offer?
• Does TennCare offer transportation?
• What services does TennCare have for children?

• What is an MCO?
• Can I change my MCO?

• I have TennCare, what pharmacy can I go to?
• What medicines are covered under TennCare?
• What is prior approval? Why would I need it?
• If I lose my TennCare, I won't be able to afford my medications. What can I do?
• What is the Prescriber Attestation List?

• What is an appeal?
• What is the difference between eligiblity/administrative and medical appeals?
• How long do I have to file an appeal?
• Will I get back on TennCare if I file an appeal?
• How long will TennCare take to answer my appeal?
• What is a fair hearing?
• Do I need a lawyer for a fair hearing?

• What does the Children's Advocacy Program do?
• Who can file an appeal?
• How do I file an appeal?
• What is the difference between a regular appeal and an expedited appeal?
• Are custody issues appealable through TennCare?
• Is there more than one appeal form for different TennCare services?
• What should I do if an appeal is denied?
• How long do I have to wait before an appeal can be filed?
• Does DCS send all staffings to the TennCare Children's Advocacy Program?
• If a child in state custody is not on TennCare whom do I call?

• What is HIPAA?
• Does the rule require my doctor to send my medical records to the government?
• What does the HIPAA Privacy Rule do?
• Why is the HIPAA Privacy Rule needed?

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