As a CoverKids member you have a right to quality care and to be treated with dignity and respect. Learn more here.
Your Rights & Responsibilities
We want you to be treated with respect and in a dignified way and be satisfied with your health plan. You have many rights as a CoverKids member. You also have responsibilities – what you must do in order to get your health care benefits.
Your Member Rights & Responsibilities can be found in Part 6 of your member handbook.
Your Civil Rights
If you think you have been treated differently, here’s information that can help you. We obey federal and state civil rights laws. We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion or sex. If you think you were treated differently for any of these reasons, you can file a complaint.
Your Right To Appeal
If you’re having problems with your health care or CoverKids, we want to hear from you. You can call or email us. But you also have the right to file an appeal.
There are two different kinds of appeals:
1) Administrative Appeals are for problems like getting or keeping TennCare, disagreeing with the kind of TennCare you have, or if you think your income or co-pay amounts are wrong. These appeals are handled by the Eligibility Appeals Unit at TennCare Connect. There are two ways to handle your appeal:
- Appeal by phone by calling TennCare Connect free at 1-855-259-0701.
- Or, appeal in writing. Please write your appeal on plain paper. Information about what you should include can be found in Part 5 of your member handbook. Mail to:
Eligibility Appeals Unit
P.O. Box 23650
Nashville, TN 37202-3650
Keep a copy of your appeal. Write down the date that you mailed it to TennCare Connect.
You only have 30 days to appeal after you find out that there is a problem. Someone who has the legal right to act for you can also file an appeal for you.
2) Medical Appeals are for problems with your health care. You have the right to appeal if:
- CoverKids says no when you or your doctors ask for healthcare
- Or CoverKids stops or changes your healthcare
- Or you have to wait too long to get healthcare
- Or you have healthcare bills you think CoverKids should have paid for but didn’t.
There are several ways to handle your Medical Appeal/Member Grievance:
- Call us first at 1-888-325-8386, Monday through Friday, 8 a.m. until 6 p.m., Eastern Time. TTY: 1-866-591-2908
- If you want to appeal in writing, write your appeal on plain paper.
- Or you can download the form and fill it out.
- Someone who has the legal right to act for you can also file an appeal for you.
- Mail to:
BlueCross BlueShield of Tennessee
Commercial Member Grievance
1 Cameron Hill Circle, Suite 0019
Chattanooga, TN 37401-0019
Member Grievances – How to appeal healthcare problems:
You have 180 days after you find out there’s a problem to appeal.
- For care or medicine you still need, you have 180 days after CoverKids says we won’t pay for the care.
- For healthcare bills you think CoverKids should pay, you have 180 days after you get your first bill.
- For care you paid for, you have 180 days after you pay for the care.
More information about appeals can be found in Part 5 and Part 6 of your member handbook.