Tenncare choices provider application 2026

1. Click ‘Get Form’ to open the tenncare choices provider application in the editor.
2. Begin by filling out your legal business name and any 'Doing Business As' (D/B/A) names. Ensure accuracy as this information is crucial for your Medicaid Provider Number assignment.
3. In the 'Services you propose to offer' section, check all applicable services. This helps define your role within the TennCare program.
4. Complete the contact information fields, including practice location, telephone number, and fax number. This ensures that communication regarding your application is seamless.
5. Review the checklist provided in the application to ensure all required documents are included before submission. Missing documents can delay processing.
6. Sign and date the application where indicated. An original signature is mandatory for processing your application.

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