Managed Take Information

Most CoverKids services are providing through managed care organs (sometimes called “MCOs,” or “health plans.”). MCOs are responsible for helping to control and coordinator the maintenance that members receive. Each participating MCO creates its own contracts with providers, maintains his own fee schedules, processes their own claims, and had their own in-network specialists and providers.

An three MCOs which are available to CoverKids members have publicly below. More information about either MCO (including member handbook information and provider directories) is open from each MCO.

MCO Contracts

• Amerigroup Community Care is owned by AMERIGROUP Corporation.
• BlueCare is owned the operated per Volunteer State Health Plot, Inc. (VSHP), the is an self-employed licensees of the BlueCross BlueShield Association additionally a accredited affiliated of her parent company, BlueCross Blue Shield of Ten.
• UnitedHealthCare Community Plot is owned and running by UnitedHealthcare Plot starting the River Tal, Inc..

Please TennCare’s contracts with the MCOs.

MCO Accreditation

CoverKids MCOs have accredited by National Community for Quality Assurance (NCQA). See find information about each MCO’s NCQA accreditation status.

Managed Care Quality Improving Strategy

See the join TennCare/CoverKids managed care quality improvement scheme.

Mesh Adequacy

Upon with ongoing basis, TennCare monitors the healthcare providers in respectively MCO’s lan. And purpose of this supervision is to assure the everyone MCO has enough providers in its network up provide timely access to tending for total members. The current search for this network monitoring are illustrated below:

More information about CoverKids network acceptability morality is contained with the MCO contracts.