How to Get Credentialed with TennCare in Tennessee
Quick Overview
Timeline
30 - 60 days
CAQH
Not Required
Re-credentialing
Every 5 year(s)
Delegated
No
Tennessee-Specific Requirements
Medicaid Information: Tennessee
Agency: Tennessee Division of TennCare
Program: TennCare
Portal: https://www.tn.gov/tenncare
Phone: 1-800-852-2683
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Tennessee.
Prepare Your Application
Complete TennCare's provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to TennCare.
Track & Follow Up
Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with TennCare?
Our specialists handle the entire TennCare enrollment process: applications, follow-ups, and approvals in Tennessee.
Required Documents Checklist
Background Check
Federal/state background check required for Medicaid enrollment
CV/Resume
Work history required
Malpractice Insurance
ConditionalRequired in most states; some state programs waive for government employees
Medical License
NPI Certificate
Enrollment Forms
TennCare Provider Enrollment
RequiredFree Tools for Your TennCare Enrollment
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Key Credentialing Terms
- Capitation
- A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- Managed Care
- A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
- Network Adequacy
- The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
Credentialing Checklist
Make sure you have everything ready before applying to TennCare.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National1-800-852-2683
Mon-Fri 8am-5pm
Provider Services
National1-800-852-2683
Claims & Billing
National1-800-852-2683
Quick Links
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.