SCREENING AND ELIGIBILITY
Elements of TennCare Kids exams
Your patients ages 20 and younger covered by BlueCare Tennessee are eligible for well-care visits, including members who need prenatal care services from an OB provider. Review the documentation and screening requirements below.
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Documentation requirements
Documentation for each well-child exam should include:
- All seven components of an EPSDT exam
- All appointments for other health care, including dental care
- The reason for not performing any component of the examination
- Any service declined by the member
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Screening components
EPSDT checkups have seven components
- Comprehensive health and developmental history
- Comprehensive unclothed physical examination including measurements
- Appropriate immunizations
- Appropriate vision and hearing testing
- Appropriate laboratory tests
- Dental screening services – Children should be referred to a pediatric dentist by age 3. If needed, you can refer children as young as 6 months old for dental care.
- Health education/anticipatory guidance
After the EPSDT exam, providers should schedule follow-up appointments for any medical or behavioral conditions discovered during the checkup. If you need help facilitating a referral to a specialist, please call the Provider Service line for your patient's plan.
No-cost Transportation
Your patients’ BlueCare Tennessee benefits include transportation to and from TennCare-covered services and the pharmacy. They can schedule transportation online or by calling our transportation vendor, Verida.
VACCINES FOR CHILDREN (VFC) PROGRAM
Vaccine reimbursement
Your practice can get payments for administering vaccines under the federal VFC program by registering with the Tennessee Immunization Information System. If you’re interested in enrolling in the VFC Program or would like a Starter Kit, please email VFC.Enrollment@tn.gov.
LEARN MORERESOURCES FOR WELL-CHILD CARE
Information you need
As a network provider, we know you're dedicated to improving the health of your patients. We've created these resources to make sure you have what you need.
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TennCare Kids Tool Kit
We look forward to working with your practice to improve EPSDT rates across Tennessee. Review these documents for coding information, best practices and more.
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Community Outreach Efforts
We have a dedicated team ready to help you engage with and encourage patients to get preventive care. We're here to help you develop a customized outreach strategy for your practice. To learn more, call 1-800-771-0217.