Introduction to TennCare
Transportation
For
non-emergency transports, call the Regional
TennCare Transportation office at 1-800-483-6743
HOURS
OF OPERATION: 8 a.m. - 4:30 p.m.
Monday through Friday. Voice mail is also available and calls are
returned the same day. Instructions for
accessing transportation services after normal operating hours is included in
the voice mail message.
You
must provide the following information in order to schedule a trip:
1. Type of transport: Non-emergency ambulance,
wheelchair
2. Date of transport: 5 working days notice is requested
unless medically necessary. If
medically necessary, physician’s
statement of medical necessity must be provided.
3. Time of appointment or transport needed.
4. Patient information: Name, address, social security
5. Destination - medical provider, name,
address and phone
Since
1994, Community Service Agencies across the state of Tennessee have contracted
to implement this program for many of the Managed Care Organizations (MCOs) and
Behavioral Health Organizations (BHOs) serving TennCare patients. The MCOs partnering with the Community
Service Agencies are: TennCare Select, Universal Care, Access Med…Plus,
Xantus. The agency also provides
services on behalf of Tennessee Behavioral Health and Premier who operate under
the umbrella of Magellan Health.
Patients
must meet the following criteria to be eligible:
1. Must be a TennCare enrollee.
2. Must have no other means of
transportation
3. Transportation must be for services
covered by TennCare.
4. Transportation must be to and/or from a
medical facility that
accepts the patient’s TennCare plan.
This requirement has one exception: Medicare-TennCare dual
eligibility. In this case, the medical
service to which transportation has been requested, must be a service covered
by the enrollee's TennCare plan.
Outline
of Responsibilities
The
patient, or designee, must call the local
TennCare Transportation office to schedule transportation for either
conventional (including car, taxi, bus. Mini-van or van) or wheelchair
transportation.
Five (5) working days’ notice is requested unless a physician provides a statement of medical necessity. The patient also must provide all information necessary to determine his/her eligibility.
MEDICAL PROVIDER:
If
a medical facility is discharging or transferring a patient to another
facility, it is the responsibility of the
discharging facility to call for transport authorization. Should the
patient require conventional or wheelchair transport, the TennCare
Transportation client care representative must screen the patient or a family
member for eligibility.
Should
the patient need non-emergency ambulance transportation, the facility must
provide a statement of medical necessity for justifying the use of an ambulance
for transport. The facility should also
be prepared to supply the following information:
* Time
of transport
* Place of departure and destination
* For non-emergency ambulance, any special
* Patient name, address & social
security number
* MCO or BHO name and TennCare ID number
COMMUNITY SERVICE AGENCY:
The
Community Service Agency (CSA) client care representative must determine eligibility of each
patient.. CSA client care
representative is also responsible for scheduling transportation in the most
cost effective and appropriate manner..
TRANSPORTATION VENDORS:
* Pick Up
of patients as scheduled
* Deliver patient to appointment
on time
* Treat all patients with
courtesy and respect
* Drive safely and behave in a
professional manner
* Return patient home after appointment
MANAGED CARE/ BEHAVIORAL HEALTH ORGANIZATIONS:
The
Managed Care or Behavioral Health Organizations (MCOs & BHOs) assure that a
transportation network has been established for their members. In addition,
MCOs set the standards or requirements for TennCare Transportation based on
federal regulations and guidelines. The Community Services Agency
provides transportation brokering services on behalf of the following agencies:
TennCare Select, Access…MedPLUS, Universal Care, Xantus Healthcare and Premier
and Tennessee Behavioral Health through Magellan Health.
Problems
with transportation issues should be reported
to the local TennCare Transportation office. We welcome your comments and suggestions.
Upper Cumberland
Community Services Agency
TennCare Transportation
417 East Broad Street
Cookeville TN 38501
Toll Free: 1-800-483-6743
Putnam County 372-8719
Fax: 931-526-1464
Serving Cannon, Clay, Cumberland, DeKalb, Fentress,