Verified October 10, 2026 against the statutes, regulations and sources cited below. General information, not legal advice. All states
What providers miss in Tennessee
- Tennessee is one of few states with a published form that lets a provider, not just a patient, ask the regulator to review a plan's network adequacy.
- Plans must accept and begin processing an application as early as 90 days before a provider's expected start date.
Does Tennessee have an any willing provider law?
No any willing provider law for medical providers was confirmed.
How long can a plan take to credential a provider in Tennessee?
Plans must respond within 90 days to a clean CAQH application. For a new provider joining a participating group, the plan must report status within five business days and give a result within 90 days after confirming the application is complete.
- Deadline: 90 days
- Applies to: Insurers, HMOs and PPOs; providers submitting a clean CAQH application
Citation: Tenn. Code Ann. 56-7-1001; 56-7-1009
What network adequacy rules apply in Tennessee?
Managed health insurance issuers must keep adequate and sufficient networks. A provider can ask the Department of Commerce and Insurance for a network adequacy and sufficiency review, for example over too few primary care providers within 30 miles or 30 minutes, or too few specialists.
Citation: Tenn. Code Ann. 56-7-2356
Provider request for a network adequacy review
The Department publishes a provider version of its Network Adequacy and Sufficiency Review Request Form under 56-7-2356(h). It is mailed, emailed or faxed to Consumer Insurance Services with a narrative of the problem.
Citation: Tenn. Code Ann. 56-7-2356(h)
TennCare credentialing timeline
TennCare managed care contractors must completely process a credentialing application within 30 calendar days of receiving a complete one with a signed provider agreement, meaning approve and load the provider or deny.
Citation: TennCare contractor risk agreement
Will the Tennessee insurance department take a provider complaint?
- Tennessee Department of Commerce and Insurance
Who oversees Medicaid managed care plans in Tennessee?
- Division of TennCare
Turned down by a plan in Tennessee?
We read the denial, check which of these rules reach that plan, and prepare the reconsideration request, the access-gap evidence and any regulator complaint the law supports; you sign and send them, and we track every deadline. Self-funded employer plans follow federal law, not Tennessee's. A rejection review is $249, credited toward a dispute.