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Policies & Procedures

These are TennDent's Policies & Procedures. TennDent Members have the right to read and comment on these documents.

If you would like a printed copy of any of these documents, please call (877) 418-6886.

2012 Quality Monitoring/Improvement Program Policy

2012 Quality Monitoring/Improvement Program Procedure

Access to Care Policy

Access to Care Procedure

Advisory Compliance Committee Policy

Advisory Compliance Committee Procedure

Claims Turnaround Time Frames Complaince Policy

Claims Turnaround Time Frames Compliance Procedure

Coordination of Dental Services with Department of Health Policy

Coordination of Dental Services with Department of Health Procedure

Coordination of Quality Monitoring/Improvement (QMP) Activities Policy

Coordination of Quality Monitoring/Improvement (QMP) Activities Procedure

Coordination with Managed Care Organizations Policy

Coordination with Managed Care Organizations Procedure

Coverage Limits Policy

Coverage Limits Procedure

Credentialing Committee Policy

Credentialing Committee Procedure

Declined Dental Services Documentation Procedure

Declined Dental Services Policy

Dental Director Policy

Dental Director Procedure

Dental Records Standards and Review Policy

Dental Records Standards and Review Procedure

Document and Records Management Procedure – Member Communications

Emergency or Urgent Treatment Policy

Emergency or Urgent Treatment Procedure

Evaluation Criteria Policy

Evaluation Criteria Procedure

Exclusion Database Search Policy

Exclusion Database Search Procedure

Executive Leadership Panel Policy

Executive Leadership Panel Procedure

HIPAA Access Control Policy

HIPAA Assigned Security Responsibility Policy

HIPAA Audit Controls Policy

HIPAA Business Associate Contract and Other Arrangement Policy

HIPAA Computer Use Policy

HIPAA Data Backup and Contingency Planning Policy

HIPAA Data Backup Procedure

HIPAA Device and Media Control Policy

HIPAA Device and Media Control Procedure

HIPAA Electronic Information Accessibility and Usage Policy

HIPAA EPHI Integrity Policy and Procedure

HIPAA Facility Access Controls Policy

HIPAA Incident Response and Reporting Policy

HIPAA Incident Response and Reporting Procedure

HIPAA Information Access Management Policy

HIPAA Information Access Management Procedure

HIPAA Passwords Policy

HIPAA Periodic Evaluation of Security Policies and Procedures

HIPAA Person or Entity Authentication Policy

HIPAA PHI Member Confidentiality and Compliance Procedure

HIPAA Personal Health Information (PHI) Policy

HIPAA Risk Analysis Procedure

HIPAA Security Awareness and Training Policy

HIPAA Security Awareness and Training Procedure

HIPAA Security Compliance Policy

HIPAA Security Management Policy

HIPAA Security Verification and Validation Policy

HIPAA Server, Desktop, and Wireless Computer System Policy

HIPAA System Security Procedure

HIPAA Transmission Security Policy

HIPAA Workforce Security Policy

HIPAA Workstation Acceptable Use Policy

Informing Network Dental Providers Policy

Informing Network Dental Providers Procedure

Initial Credentialing of Providers Policy

Initial Credentialing of Providers Procedure

Limits/Capitations/Delays Policy

Limits/Capitations/Delays Procedure

Member Appeals Policy

Member Appeals Procedure

Member Complaints Policy

Member Complaints Procedure

Member Information for Limited English Proficiency (LEP) Groups Policy

Member Information for Limited English Proficiency (LEP) Groups Procedure

Member Responsibilities Policy

Member Responsibilities – Notification of Provider Changes Procedure

Member Rights and Responsibilities Procedure

Member Rights Policy

Member Rights Regarding New Member Mailings Procedure

Network Provider Education Policy

Network Provider Education Procedure

Non-Discrimination: Complaints of Discrimination Procedure

Non-Discrimination Compliance Policy

Non-Discrimination: Interpreter and Translation Services Procedure

Non-Discrimination: Member Handbook Inclusions Procedure

Non-Discrimination: Member Materials Development Procedure

Non-Discrimination: Member Materials Procedure

On-Site Dental Office Review Policy

On-Site Dental Office Review Procedure

Out-of-Network Providers Policy

Out-of-Network Providers Procedure

Over- and Under-Utilization Policy

Over- and Under-Utilization Procedure

Peer Review Committee Policy

Peer Review Committee Procedure

Policies, Procedures, and Document Management Policy

Policies, Procedures, and Document Management Procedure

Prior Authorization of Treatment Policy

Prior Authorizaton of Treatment Procedure

Provider Grievance and Appeal Policy

Provider Grievance and Appeal Procedure

Provider Remedial/Corrective Action Plan Policy

Provider Remedial/Corrective Action Plan Procedure

Qualified Dental Professionals Policy

Qualified Dental Professionals Procedure

Quality Monitoring of Credentialing Files Policy

Quality Monitoring of Credentialing Files Procedure

Quality Monitoring/Improvement Committee Policy

Quality Monitoring/Improvement Committee Procedure

Quality of Care Policy

Quality of Care Procedure

Record Retention Policy

Record Retention Procedure

Recredentialing of Providers Policy

Recredentialing of Providers Procedure

Specialist Referral Policy

Specialist Referral Procedure

Standards for Facilities Policy

Standards for Facilities Procedure

TENNderCare (EPSDT) Medically Necessary Claim Processing Criteria Procedure

TENNderCare (EPSDT) Medically Necessary Services Policy

TENNderCare (EPSDT) Outreach: Member Transportation Procedure

TENNderCare (EPSDT) Outreach Policy

TENNderCare (EPSDT) Outreach: Documentation Procedure

TENNderCare (EPSDT) Outreach: Annual Plan Procedure

Tracking and Data Collection Policy

Tracking and Data Collection Reports Procedure

Utilization Management Outcome Response Policy

Utilization Management Outcome Response Procedure

Utilization Review Program Policy

Utilization Review Quality Review Audit Procedure

Contact Us

(877) 418-6886
P.O. Box 281078
Nashville, TN 37228-8501

Hearing Impaired Call:
(888) 892-4862

We are happy to help you with any questions. You can call the TennDent program at (877) 418-6886. This is a free call. The TennDent program is for TennCare members under the age of 21. Call us at (877) 418-6886 if you know of a case of fraud or abuse in the TennDent program. You do not have to tell us your name.

We do not allow unfair treatment in TennCare. No one is treated in a different way because of race, color, birthplace, religion, language, sex, age, or disability. Do you think you’ve been treated unfairly? Do you have more questions or need more help? If you think you’ve been treated unfairly, call the Family Assistance Service Center for free at 1-866-311-4287. In Nashville, call 743-2000.

¿Habla español y necesita ayuda con esta carta? Llámenos gratis al (877) 418-6886.

Need help in another language? You can call TennDent for language assistance at (877) 418-6886 or the numbers below. Interpretation and translation services are free to TennCare members.

Foreign Language Lines

Call if you need help and need to speak with someone in one of these languages:

	Arabic	(800) 758-1638
	Bosnian	(800) 758-1638
	Kurdish-Badinani	(800) 758-1638
	Kurdish-Sorani	(800) 758-1638
	Somali	(800) 758-1638
	Spanish	(800) 758-1638
	Vietnamese	(800) 758-1638

Do you need help with this information? Is it because you have a health, mental health, or learning problem or a disability? Or, do you need help in another language? If so, you have a right to get help, and we can help you. Call Customer Service at (877) 418-6886 for more information.

Do you have a mental illness and need help with this information? The TennCare Advocacy Program Line can help you. Call them for free at (800) 758-1638.

If you have a hearing or speech problem you can call us on a TTY/TDD machine. Our TTY/TDD number is (888) 892-4862.