BlueCare Tennessee Providers

Last Updated on February 19, 2024
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)

We’re Here To Support You

Throughout the COVID-19 pandemic, we made changes to help our members and providers stay safe. The National Public Health Emergency ended on May 11, 2023, so we’re taking steps to return to some of our original policies and procedures. Please continue to visit this section of the website for updates. You can also refer to the Provider Administration Manual for more information.

Below, we’ve outlined some of the steps we took in response to the COVID-19 emergency. These flexibilities expired May 11, 2023:

  • BlueCare Tennessee allowed flexibility to charge inpatient rates in the emergency room or other units where patients may need to be housed, based on intensity of service. 
  • If a hospital requested an extension for BlueCare appeals time frames past 180 days, we approved reasonable requests on a case-by-case basis.
  • Hospitals could request an extension for medical record audits and audits for inpatient and outpatient facility claims, manual collection of medical records for HEDIS, and in-office reviews for Quality and Value-based programs due to staffing shortages, overwhelmed hospital capacity or other factors. Until the national PHE ended on May 11, we reviewed requests on a case-by-case basis and made accommodations as appropriate.
  • We paid for COVID testing prior to inpatient admission separately, even if within the 72-hour window where it would normally be included in the DRG. 

These changes will remain in effect:

  • We’ve permanently added flu testing and COVID-19 tests to BlueCare's exclusive lab exception list.
  • BlueCare is permanently waiving readmission penalties for COVID-19 hospital stays, unless there’s evidence of an unsafe discharge.

For BlueCare, TennCareSelect and CoverKids lines of business unless stated otherwise.

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