BlueCare 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.
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How to fill out the Bluecare Pcp Change Form online
Filling out the Bluecare PCP Change Form online can streamline your process for changing your primary care provider. This guide offers step-by-step instructions to ensure you provide all necessary information accurately and efficiently.
Follow the steps to complete the form successfully.
- Click the ‘Get Form’ button to access the Bluecare PCP Change Form and open it in a digital editor.
- Locate the 'Member Information' section. Fill out your Member ID, date of birth, and complete your name (first, middle initial, and last) accurately.
- Enter your current address, including city, state, and ZIP code. Ensure that all information is correct as it will be used for your records.
- Provide your phone number and affix your signature in the designated area. Please note that your ID card will be sent to the last reported address.
- Move to the 'Provider Information' section. Here, input the name of your new primary care provider (PCP) and the provider number where applicable.
- Fill in the new provider's address, including city, state, and ZIP code, as well as their phone number, fax number, and email address.
- Ask your new PCP to sign the form where indicated, and ensure they write the date and their NPI number.
- Indicate the reason for the change by checking the appropriate box. If you select 'Other,' please provide an explanation in the space provided.
- If applicable, remember that all PCP changes for members in DCS custody require a signed form from a DCS representative.
- Once all sections are completed, save your changes, then download, print, or share the form as needed.
Complete your Bluecare PCP Change Form online now to ensure your primary care provider is updated quickly.
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How do I contact BlueCross BlueShield of Tennessee?
Phone 1-800-292-8196. 1-800-292-8196. TRS users should call: 711 (Ask for 888-418-0008) TRS users should call: 711 (Ask for 888-418-0008) EMAIL US.
Is TennCare and BlueCare 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.
How do I change my PCP Blue Cross Blue Shield Texas?
You can change your PCP at anytime. Call a Personal Health Guide 24 hours a day/7 days a week at 1-866-355-5999 to get help finding, choosing and changing your PCP. You can also visit .bcbstx.com/trsactivecare to log into Blue Access for MembersSM and change your PCP online.
What is the out of pocket limit for BCBS Tennessee?
Network providers $1,000/ single and $2,000/employee + child(ren), and $2,000/ family. For out-of-network providers: $5,000/single and $10,000/employee + child(ren), and $10,000/family. The out-of-pocket limit is the most you could pay in a year for covered services.
How do I change my PCP for BlueCare TN?
PCP Change form Your patients can also initiate the request by: 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.
Is Blue Cross Blue Shield of Tennessee a PPO or HMO?
Blue Cross Blue Shield of Tennessee's Preferred Provider Organization (PPO) is a select network of health care professionals, including many of the area's most respected doctors and hospitals.
How do I change my primary care at TennCare?
You can ask to change your health plan by calling TennCare Member Medical Appeals at 1-800-878-3192. For more information about changing your health plan please see your member handbook.
How do I change my PCP on Bcbstx?
You can change your PCP at anytime. Call a Personal Health Guide 24 hours a day/7 days a week at 1-866-355-5999 to get help finding, choosing and changing your PCP. You can also visit .bcbstx.com/trsactivecare to log into Blue Access for MembersSM and change your PCP online.
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