Auto Assignment. 2.4.4.6.1 TENNCARE will auto assign an enrollee to an MCO, in specified circumstances, including but not limited to, the enrollee does not request enrollment in a specified MCO, cannot be enrolled in the requested MCO, or is an adult eligible as a result of receiving SSI benefits. 2.4.4.6.2 The current auto assignment process does not apply to children eligible for TennCare as a result of being eligible for SSI or children in the state’s custody. 2.4.4.6.3 There are four different levels to the current auto assignment process: 2.4.4.6.3.1 If the enrollee was previously enrolled with an MCO and lost TennCare eligibility for a period of two (2) months or less, the enrollee will be re-enrolled with that MCO. 2.4.4.6.3.2 If the enrollee has family members in an MCO (other than TennCare Select), the enrollee will be enrolled in that MCO. 2.4.4.6.3.3 If the enrollee is a newborn, the enrollee will be assigned to his/her mother’s MCO. 2.4.4.6.3.4 If none of the above applies, the enrollee will be assigned using default logic that randomly assigns enrollees to MCOs (other than TennCare Select). 2.4.4.6.4 TENNCARE may modify the auto assignment algorithm to change or add criteria including but not limited to quality measures.
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Auto Assignment. 2.4.4.6.1 2.4.4.2.1 TENNCARE will auto assign an enrollee to an MCO, in specified circumstances, including but not limited to, the enrollee does not request enrollment in a specified MCO, cannot be enrolled in the requested MCO, or is an adult eligible as a result of receiving SSI benefits.
2.4.4.6.2 2.4.4.2.2 The current auto assignment process does not apply to children eligible for TennCare as a result of being eligible for SSI or children in the state’s State custody.
2.4.4.6.3 2.4.4.2.3 There are four different levels to the current auto assignment process:
2.4.4.6.3.1 2.4.4.2.3.1 If the enrollee was previously enrolled with an MCO and lost TennCare eligibility for a period of two (2) months or less, the enrollee will be re-enrolled with that MCO.
2.4.4.6.3.2 2.4.4.2.3.2 If the enrollee has family members in an MCO (other than TennCare Select), the enrollee will be enrolled in that MCO.
2.4.4.6.3.3 2.4.4.2.3.3 If the enrollee is a newborn, the enrollee will be assigned to his/her mother’s MCO.
2.4.4.6.3.4 2.4.4.2.3.4 If none of the above applies, the enrollee will be assigned using default logic that randomly assigns enrollees to MCOs (other than TennCare Select).
2.4.4.6.4 2.4.4.2.4 TENNCARE may modify the auto assignment algorithm to change or add criteria including but not limited to quality measuresmeasures or cost or utilization management performance.
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Sources: Agreement for the Administration of Tenncare Select
Auto Assignment. 2.4.4.6.1 TENNCARE will auto assign an enrollee to an MCO, in specified circumstances, including but not limited to, the enrollee does not request enrollment in a specified MCO, cannot be enrolled in the requested MCO, or is an adult eligible as a result of receiving SSI benefits.
2.4.4.6.2 The current auto assignment process does not apply to children eligible for TennCare as a result of being eligible for SSI or children in the state’s custody.
2.4.4.6.3 There are four different levels to the current auto assignment process:
2.4.4.6.3.1 If the enrollee was previously enrolled with an MCO and lost TennCare eligibility for a period of two (2) months or less, the enrollee will be re-enrolled with that MCO.
2.4.4.6.3.2 If the enrollee has family members in an MCO (other than TennCare Select), the enrollee will be enrolled in that MCO.
2.4.4.6.3.3 If the enrollee is a newborn, the enrollee will be assigned to his/her mother’s MCO.
2.4.4.6.3.4 If none of the above applies, the enrollee will be assigned using default logic that randomly assigns enrollees to MCOs (other than TennCare Select).
2.4.4.6.4 TENNCARE may modify the auto assignment algorithm to change or add criteria including but not limited to quality measuresmeasures or cost or utilization management performance.
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