Get the free TennCare Provider Refund Request form

SEND THIS COMPLETED FORM TO: State of Tennessee Division of Tenner, Floor 4 East Attention: Accounting 310 Great Circle Road Nashville, TN 372431700 or Fax # (615)5323479 Attn: RefundsTENNCARE PROVIDER

How to fill out tenncare provider refund request

How to fill out tenncare provider refund request

1. To fill out the TennCare provider refund request, follow these steps:
2. Start by gathering all the necessary information and documents, including the provider's name, address, and contact information, the recipient's name and TennCare ID, the date of service, the amount being refunded, and any supporting documentation.
3. Once you have all the required information, visit the TennCare website and navigate to the provider portal or login to the provider portal if you already have an account.
4. In the provider portal, locate the refund request section and click on it.
5. Fill out the refund request form with the requested information. Be sure to provide accurate and complete details to avoid any delays or rejections.
6. Attach any necessary supporting documentation, such as copies of invoices, receipts, or explanation of benefits (EOB) forms.
7. Double-check all the information entered on the form for accuracy. Review the attached documents to ensure they are relevant and complete.
8. Submit the refund request form through the provider portal. Note that some portals may require additional confirmation or verification steps.
9. After submission, wait for confirmation of receipt or any further instructions from TennCare. Keep track of your refund request for future reference.
10. In case of any queries or issues, contact the TennCare provider support helpline for assistance.
11. Follow up on the refund request periodically to ensure its processing and resolution.

Who needs tenncare provider refund request?

1. TennCare provider refund request is needed by healthcare providers who have received payments from TennCare and need to refund a certain amount due to overpayments, billing errors, or other valid reasons.
2. This refund request is specifically for providers who participate in the TennCare program and have received payments for services provided to TennCare recipients.
3. Providers who have identified a need to refund TennCare funds are required to submit a refund request through the designated process to ensure proper documentation and handling of the refund.

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What is tenncare provider refund request?

The tenncare provider refund request is a form used by healthcare providers to request a refund for overpaid claims or duplicate payments.

Who is required to file tenncare provider refund request?

Healthcare providers who have received overpaid claims or duplicate payments from tenncare are required to file a refund request.

How to fill out tenncare provider refund request?

To fill out the tenncare provider refund request, providers must include their information, details of the overpaid claims, and supporting documentation.

What is the purpose of tenncare provider refund request?

The purpose of the tenncare provider refund request is to reimburse healthcare providers for overpaid claims or duplicate payments.

What information must be reported on tenncare provider refund request?

Providers must report their contact information, the reason for the refund request, details of the overpaid claims, and any supporting documentation.