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  • Blue Cross Blue Shield Of Tennessee Predetermination Form

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Predetermination Request Form Confidential Date Submitted: Contact Name: Contact phone #: Please complete this form when requesting predetermination of benefits for a specific procedure or service.

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Medicare + Medicaid = BlueCare Plus Tennessee It's for those who qualify for TennCare. With these plans, you keep your Medicare and Medicaid benefits. Plus, you get extra benefits and help from a whole care team.

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.

Routine vision and dental services are covered for members under the age of 21. Vision services are covered for members over 21 if they are due to certain illnesses or accidental injuries.

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.

We've supported TennCare members for more than 30 years through BlueCare Tennessee, a subsidiary of BlueCross BlueShield of Tennessee chosen by the state to help manage its Medicaid program.

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

If an urgent/emergent clinical situation exists outside of a hospital emergency room, please call 1-888-258- 3864 immediately with the appropriate clinical information for an expedited review to obtain a prior authorization. You can obtain the CPT-4 codes at bcbst.com that Magellan Healthcare authorizes.

Call BlueCare at 1-800-468-96981-800-468-9698 or TennCareSelect at 1-800-263-54791-800-263-5479, and we will provide the assistance you need.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232