A decision is adverse or decision support is needed
Appeal a TennCare or MCO service action
Use the complete notice and the current TennCare medical-appeal route for denied, delayed, reduced, suspended, or terminated services.
Official sources checked 2026-07-29
Start here
File a TennCare medical appealBefore you start
- Complete notice and envelope, service request, plan and authorization, issuing entity, action and effective date, requested result, medical and functional evidence, representative permission, and instructions.
Who to contact
Use the official TennCare, MCO, DDA regional intake, LTSS Help Desk, Beneficiary Support System, crisis, or protective-reporting route that owns this step.
Step by step
- Call the health plan first about the service problem and document the response.
- File through the notice's route or TennCare's current telephone, online, mail, or fax medical-appeal route.
- Preserve proof, request needed records, and ask about expedited handling only when the official emergency standard may apply.
Expected next
A health-plan response, appeal acknowledgment, corrected action, information request, review, hearing event, or written decision.
Save this proof
Notice, envelope, health-plan contact, appeal, proof, records, evidence, correspondence, and decisions.
If this stalls or the answer is no
Call TennCare Member Medical Appeals at 1-800-878-3192 or use the Beneficiary Support System.
Beyond Childhood planning aid
Appeal a TennCare or MCO service action checklist
A Beyond Childhood planning aid derived from the cited official sources.
- Owner and program
- Date started
- Documents supplied
- Written result or confirmation
- Current open dependency
- Next event and date
- Escalation contact
Derived from Get ECF CHOICES rights, complaint, and appeal help, File a TennCare medical appeal
Official resources
Limits
The complete notice controls. The official page currently states a 60-day medical-appeal period, but this guide does not calculate the deadline, continued-benefit rights, or eligibility for expedited handling.
Beyond Childhood’s checklists and prompts are planning aids derived from official sources. They are not official forms, legal advice, eligibility decisions, or guarantees of funding, capacity, quality, or service.