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Prior Authorization Form Tenner Extended Opioid Use Clinical Exceptions: Burn/Corrosion Recovery, Long Term Care, Sickle Cell Disorder Access this PA form at https://tenncare.magellanhealth.com/static/docs/Prior×Authorization×Forms/Tenner×Exceptions×Opioid×PA_Form.pdf If
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How to fill out tenncare extended opioid use

01
To fill out the TennCare extended opioid use form, follow these steps:
02
Obtain the form from the TennCare website or your healthcare provider.
03
Read the instructions carefully to understand the requirements and eligibility criteria.
04
Provide your personal information, including name, address, phone number, and date of birth.
05
Fill in your current healthcare coverage details, including the insurance provider and policy number.
06
Answer the questions regarding your prolonged opioid use and medical condition accurately.
07
Include any supporting documents or medical records that may be required.
08
Review the completed form for any errors or missing information.
09
Sign and date the form.
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Submit the filled-out form through the designated channels, such as mailing it or delivering it in person.
11
Wait for a response from TennCare regarding your extended opioid use application.

Who needs tenncare extended opioid use?

01
TennCare extended opioid use is for individuals who meet the following criteria:
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- Have a legitimate medical need for extended opioid use.
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- Are currently enrolled in TennCare or eligible for TennCare coverage.
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- Have a prescribing healthcare provider who believes that extended opioid use is medically necessary.
05
- Have not exceeded the maximum dosage or duration limits for opioid prescriptions as defined by TennCare.
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It is important to consult with your healthcare provider or TennCare representative to determine if you meet the specific eligibility requirements for TennCare extended opioid use.
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TennCare Extended Opioid Use is a program that allows for extended coverage of opioid medications for qualified individuals in Tennessee.
Healthcare providers who prescribe opioid medications to TennCare patients are required to file TennCare Extended Opioid Use.
Healthcare providers can fill out TennCare Extended Opioid Use by completing the necessary forms and submitting them to TennCare.
The purpose of TennCare Extended Opioid Use is to provide extended coverage for opioid medications to help manage pain for qualified individuals.
Healthcare providers must report the patient's information, the prescribed opioid medication, and the reason for extended coverage on TennCare Extended Opioid Use.
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