BlueCare Tennessee Providers

Last Updated on September 8, 2021
Please refer to this section for helpful information about treating BlueCare Tennessee members during the COVID-19 state of emergency.

A Message From Todd Ray (Please note updates are frequent)


Dear Valued Provider,

With the recent increase in COVID-19 cases, it’s more important than ever that we work together to provide the best care possible for our members. This includes encouraging them to get vaccinated.

Last month, following a three-month application review, the Pfizer-BioNTech vaccine received full approval from the Food & Drug Administration for those age 16 and older. The vaccine met rigorous standards for safety, effectiveness and manufacturing that the FDA requires for designation as an approved product. You can learn more about this from Dr. Andrea Willis, BlueCross senior VP/chief medical officer, in a recent article in The Tennessean.

We’re doing our best to help you stay informed by updating this site regularly. You can also find more information on state and federal guidelines by visiting the State of Tennessee and CDC COVID-19 websites. You’ll find the links below.

Thank you for your dedication and the care you’ve shown our members during this challenging time.

Sincerely,

Todd Ray, Senior Vice President, Corporate Provider Network Management and Medicare Products

We’d like to point you toward helpful resources, where you can get daily updates about providing treatment during the COVID-19 emergency:

  • Read more about the State of Tennessee’s response to the disease on the Tennessee Department of Health website. Find updates from the Division of TennCare here.
  • Click here for the latest information from the Centers for Disease Control and Prevention (CDC).

For more general information about coronavirus resources available to the public, you may also call the Tennessee Coronavirus Public Information Line at 1-877-857-2945.

We’re Here To Support You

During surges in COVID-19, we took significant steps to remove barriers for members to receive care while streamlining certain necessary requirements for our providers. As cases of COVID-19 rise in our state, we’re reviewing our policies and may adjust them as needed to make it easier for providers to deliver necessary care. Steps we’ve taken to date include:

  • Beginning Aug. 13, 2021, BlueCare Tennessee will resume waiving the prior authorization requirement for initial post-acute care reviews (skilled nursing facility, rehab and LTACH) to support rapid placement and discharge of currently hospitalized patients who can be safely discharged to another setting. Until further notice, authorization isn’t required before moving patients from the acute to post-acute care settings.
  • BlueCare Tennessee is allowing flexibility to charge inpatient rates in the emergency department or other units where patients may need to be housed, based on intensity of service.
  • We’ve permanently added flu testing and COVID-19 tests to BlueCare's exclusive lab exception list.
  • If a hospital requests to extend appeals timeframes past 180 days, we’ll approve reasonable requests on a case-by-case basis.
  • BlueCare suspended all medical record requests and audits for inpatient and outpatient facility claims, and postponed manual collection of medical records for HEDIS and in-office reviews for Quality and Value-based programs, through March 31, 2021. Moving forward, if hospitals request an extension of these due to staffing shortages, overwhelmed hospital capacity or other factors, we’ll review on a case-by-case basis and make accommodations as appropriate.
  • BlueCare is paying for COVID testing prior to inpatient admission separately, even if within the 72-hour window where it would normally be included in the DRG.
  • BlueCare is permanently waiving readmission penalties for COVID-19 hospital stays, unless there’s evidence of an unsafe discharge.

We’ll keep you updated on changes as they occur.

BlueCare Tennessee Telehealth and Telephonic/Audio-Only Services Update

COVID-19 Emergency Disclaimer

During the COVID-19 emergency, we’ll continue to follow the COVID-19-related policies and processes listed in this section of the BCBSTupdates website. Many of our decisions are guided by federal and state mandates, which occur frequently, so we encourage you to refer to this site daily. Should we decide to make a non-mandated change to a policy or process listed in the provider Q&As during the COVID-19 emergency, we’ll post the update 30 days in advance on this site.


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