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  • Wellcare Change Pcp Form

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Print Name of Member or Responsible Party Signature of Member or Responsible Party Provider (Staff) Signature Date Biological Parent? Yes No If No the name of the Responsible Party must match exactly what WellCare has on file for Responsible Party. Wi.

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Call 1-833-870-5500 (toll free), Or go online at ncmedicaidplans.gov. You can ask your provider which health plans they work with....But, if you want to change your PCP you may: Call the Medicaid Contact Center at 888-245-0179, or. Call your local DSS Office, or. Go to Find a provider to see who is taking new patients.

Call Member Services at 1-855-690-7784 (TTY 711). Fax completed form to 1-866-840-4993. Incomplete forms will not be accepted.

TennCare Kids is a full program of checkups and health care services for children from birth through age 20 who have TennCare.

There are several ways to report a change. You only have to pick one: Call TennCare Connect for free at 855-259-0701. Use your TennCare Connect online account at https://tenncareconnect.tn.gov.

Calling customer service: BlueCare: 1-800-468-9698 TennCareSelect: 1-800-263-5479. Faxing the completed member PCP Change Request form to 1-888-261-9025. The form can be found in their member handbook. Printing a temporary ID card from their BlueAccessSM account at bluecare.bcbst.com.

TennCare Kids checkups are FREE for children who are enrolled in TennCare from birth until age 21. This includes checkups for vision, hearing, dental and mental health.

TennCare is a third party payer. Some TennCare enrollees have both TennCare and other health insurance, which means there are two third party payers.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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