September 18, 2022

Helping children with challenges adapt to school

Every school year, we share opportunities through the state’s TennCare program to provide integrated care to children facing unique challenges in the school system. They may need physical, occupational and/or speech therapy, nursing support services and/or behavioral health treatment. Primary care providers (PCPs) have an important role in helping these children and supporting effective learning.

Under the federal Information Data Exchange System education requirement, children enrolled in TennCare who need assistance may be eligible to receive medically necessary services while in a school setting. With your help and the partnership of the Tennessee Department of Education, TennCare Bureau, local school systems and other TennCare MCOs and PCPs, these children can access comprehensive health services and be assured continuity of care.

How you can help

When a school identifies a child’s support needs, federal regulations require the school to send the information to the child’s physician and request orders for the services. School districts and/or their third-party billing administrators may contact your office to obtain an order.

When you receive a request to review the child’s Individualized Education Plan order, please respond as quickly as possible. If you want to schedule a child visit or need additional assistance, please notify the school with your faxed response.

Questions?

Please contact your provider advocate if you’d like more information.

PCA-1-22-02779-C&S-News-09022022
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