TN BlueCare Primary Care Provider Change Request Form 2015 free printable template

Bluesier TennCareSelect SM Primary Care Provider Change Request Form Member Information: Please complete and fax to: 18882619025 Member ID Date of birth (month/day/year) Member Name: First MI Last

How to fill out TN BlueCare Primary Care Provider Change

How to fill out TN BlueCare Primary Care Provider Change Request

1. Obtain the TN BlueCare Primary Care Provider Change Request form.
2. Fill in your personal information including your member ID, name, and contact details.
3. Provide the name and contact information of your current primary care provider.
4. Specify the new primary care provider you wish to choose, including their name and contact information.
5. Include any additional information required, such as reasons for the change if prompted.
6. Review the completed form for accuracy.
7. Sign and date the form to authorize the change.
8. Submit the form to the designated address or through the specified method outlined by TN BlueCare.

Who needs TN BlueCare Primary Care Provider Change Request?

1. Members of TN BlueCare who wish to change their primary care provider.
2. Individuals who have had a change in their healthcare needs and require a different provider.
3. Anyone dissatisfied with their current provider and seeking a new one within the TN BlueCare network.

People Also Ask about

What is the provider line for BCBS of Tennessee?

If you have questions about working with us, please find helpful resources on this website or call our Provider Service Line at 1-800-924-7141.

What is BlueCard PPO outside of Tennessee?

BlueCard® The BlueCard Program allows you to submit claims for members of BlueCross BlueShield Plans outside of Tennessee to us for processing and reimbursement. It links network providers and Blue Cross Blue Shield Plans across the country and around the world.

Is Blue Cross Blue Shield of Tennessee a PPO or HMO?

Like many insurance companies, BlueCross BlueShield of Tennessee's product offerings include the following types of plans: PPO.

Is BlueCare and TennCare the same?

We have two TennCare plans – BlueCare and TennCareSelect. Members with specific needs may also qualify for one of our four programs – SelectKids, SelectCommunity, CHOICES, and Employment and Community First CHOICES.

Does BCBS of TN require prior authorization?

Prior Authorization Information Prior authorization is required for certain procedures, services and medications, as well as for all inpatient admissions.

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What is TN BlueCare Primary Care Provider Change Request?

The TN BlueCare Primary Care Provider Change Request is a formal process that allows members to request a change in their designated primary care provider (PCP) when needed.

Who is required to file TN BlueCare Primary Care Provider Change Request?

Members of the TN BlueCare health plan who wish to change their primary care provider are required to file this request.

How to fill out TN BlueCare Primary Care Provider Change Request?

To fill out the TN BlueCare Primary Care Provider Change Request, members need to provide their personal information, current PCP details, the desired new PCP information, and any additional required information on the form.

What is the purpose of TN BlueCare Primary Care Provider Change Request?

The purpose of the TN BlueCare Primary Care Provider Change Request is to enable members to select a new primary care provider that better meets their healthcare needs.

What information must be reported on TN BlueCare Primary Care Provider Change Request?

The information that must be reported includes the member's identification details, current primary care provider information, chosen new primary care provider information, and any relevant medical history, if applicable.