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Get Tn Tc-0159 2015-2026

DATE: I certify that the applicant s medical condition on the recertified PAE is consistent with that described in the initial certification (above) and that Nursing Facility services are medically necessary for the applicant. Must be SIGNED by a Physician (MD or DO), Nurse Practitioner, Physician Assistant, or Clinical Nurse Specialist Recert PAE Request Date TC-0159 Signature and Credentials TennCare LTSS Update: 10/2015 Date of Signature RDA 2047.

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How to fill out the TN TC-0159 online

The TN TC-0159 is a crucial form for individuals seeking long-term care services in Tennessee. Completing this form accurately ensures that applicants receive the necessary level of care suited to their medical needs.

Follow the steps to fill out the TN TC-0159 online

  1. Click ‘Get Form’ button to obtain the form. This will allow you to access the TN TC-0159 in its editable format.
  2. Enter the applicant’s name in the designated field. Make sure it matches the person's legal name.
  3. Input the applicant’s Social Security Number (SSN) accurately in the provided space. Double-check for errors.
  4. Gather and attach a recent History and Physical report or other medical records that support the applicant's needs. Ensure this document is completed within the past 365 days.
  5. If skilled nursing or rehabilitative services are being requested, ensure you have a separate Physician’s Order that includes the basis for these services.
  6. Request a Physician (MD or DO), Nurse Practitioner, Physician Assistant, or Clinical Nurse Specialist to complete the certification of the level of care required by the applicant. This must be signed and dated.
  7. Document the relevant diagnoses pertaining to the applicant’s functional and/or skilled nursing needs in the designated area.
  8. If a recertification of the PAE is required, fill out the Certification Update section. Verify that the medical condition remains consistent with the initial certification.
  9. Review all sections for accuracy and completeness before finalizing your submission.
  10. Once completed, save your changes and proceed to download, print, or share the form as necessary.

Start completing your TN TC-0159 online today to ensure timely access to necessary services.

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TennCare's health plans are AmeriGroup (part of Anthem), BlueCare and TennCare Select (part of BlueCross and BlueShield of Tennessee), and UnitedHealthcare Community Plan (part of UnitedHealthcare).

Level of Care (LOC) determinations are made by the Division of TennCare. LOC determinations include an assessment of certain functional needs-the need for assistance with Activities of Daily Living (ADLs) and an assessment of certain clinical needs.

CHOICES Group 3 is for adults (age 21 and older) with a disability and seniors (age 65 and older) who don't qualify for nursing home care but still need care to delay or prevent the need for nursing home care.

TennCare is the state of Tennessee's Medicaid program. It provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability. To get Medicaid, you must meet the income and resource limits. You can apply anytime for TennCare.

A pre-admission screening and resident review, commonly called a PASRR, is a comprehensive evaluation that ensures people who have been diagnosed with serious mental illness, intellectual, and/or developmental disabilities are able to live in the most independent long-term care settings while receiving recommended care ...

Who is eligible for Tennessee TennCare? Household Size*Maximum Income Level (Per Year) 5 $48,652 6 $55,807 7 $62,963 8 $70,1184 more rows

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