TennCare Member Appeals

Thank you for your request for information and interest in the Tennessee Division of TennCare. You may review our Public Records Policy and submit a request through our Public Records portal at https://www.tn.gov/tenncare/legal/public-records.html

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Public Records and Requests Office
310 Great Circle Rd., Nashville, TN 37243
tn.gov/tenncare<file://AG03SDCWF00523/DC57_User_Users/DCV2470/Documents/Branding%20and%20Formatting/tn.gov/tenncare>

Thank you for your request for information and interest in the Tennessee Division of TennCare. You may review our Public Records Policy and submit a request through our Public Records portal at https://www.tn.gov/tenncare/legal/public-records.html

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Public Records and Requests Office
310 Great Circle Rd., Nashville, TN 37243
tn.gov/tenncare<file://AG03SDCWF00523/DC57_User_Users/DCV2470/Documents/Branding%20and%20Formatting/tn.gov/tenncare>

Thank you for your request for information and interest in the Tennessee Division of TennCare. You may review our Public Records Policy and submit a request through our Public Records portal at https://www.tn.gov/tenncare/legal/public-records.html

[cid:image001.png@01D564A5.F8629790]
Public Records and Requests Office
310 Great Circle Rd., Nashville, TN 37243
tn.gov/tenncare<file://AG03SDCWF00523/DC57_User_Users/DCV2470/Documents/Branding%20and%20Formatting/tn.gov/tenncare>

Thank you for your request for information and interest in the Tennessee Division of TennCare. Our Public Records Policy and a link to the TennCare request submission portal are available at https://www.tn.gov/tenncare/legal/public-records.html

[TennCare Header Logo 2017]
Public Records Office
Division of TennCare
310 Great Circle Rd., Nashville, TN 37243
tn.gov/tenncare<file://AG03SDCWF00523/DC57_User_Users/DCV2470/Documents/Branding%20and%20Formatting/tn.gov/tenncare>

Thank you for your original request for information, your follow-up and interest in the Tennessee Division of TennCare. Our Public Records Policy and, should you wish to submit your request, a link to the TennCare request submission portal are available at https://www.tn.gov/tenncare/legal/public-records.html

[TennCare Header Logo 2017]
Public Records Office
Division of TennCare
310 Great Circle Rd., Nashville, TN 37243
tn.gov/tenncare<file://AG03SDCWF00523/DC57_User_Users/DCV2470/Documents/Branding%20and%20Formatting/tn.gov/tenncare>

Dear Kent Hoover,

Thank you for registering with TennCare Records Portal.

Your Login ID is:  requests@muckrock.com

If you did not submit your request through the public portal but are receiving this e-mail, an account has been created for you where you can track and monitor the status of your request, and receive any documents in response to your request.


If you have never used this system or cannot remember your password you may request a temporary password here: Request Temporary Password (https://u4037834.ct.sendgrid.net/ls/click?upn=NsSD9AJ7NC1Zn9x435-2BIaOuGAgdXOsA37oC6ARpob6k0Cx6A7eCOaHW-2B8aJuWkME-2FAPGJ81TGpzfjLY5raLGRpfXELCVg-2Bu2zASKJPNiIs8-3DRieG_IoxAM6mr-2F-2FvfG-2FGWXY47zDaWVdtttFJqF4IQ6XScAXGP78ItTt9OhRslgNYhfvY4WyaiETBd3MDkVaJSPEByaiDwHsMBzHg4Vp61Ysk3XuhB-2FT5UFWY2SdND0GOC4uyYz76aZJnX6PeefMJtqIWUf2q2DzmmZBezkH5I-2BnfjyRBLMevEvabkCbkyH1rlGUZNnSVNno-2FAMRqebTT6whw6C1uopKLpu66KUYSvNh3IufaNt-2BkgizI3xokwbeeSp30kBGjzjTX04SBNVNSEKn35bA-3D-3D)

Please login to "My Request Center" to update your account information, track the status of your request and receive requested records when they become available. This is an auto-generated email and has originated from an unmonitored email account. Please DO NOT REPLY

Dear Kent Hoover:
Thank you for your interest in public records of TennCare. Your request has been received and is being processed in accordance with the Tennessee Public Records Act ( Tenn. Code Ann. § 10-7-501 et seq.). Your request was received in this office on 4/1/2020 and given the reference number R000150-040120 for tracking purposes. Records Requested: To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

Related to the TennCare Member Appeals Process solicitation (RFP # 31865-00350), which was awarded on or about October 4, 2012. Specifically, I seek the following records:
1. The winning proposal (cost and technical);
2. All competitor proposals (cost and technical);
3. All award evaluations and evaluator notes;
4. Invoices from 2016 to present; and
5. Compliance reports from 2016 to present (including monthly reports that list timelines for all current and future work products to be submitted under this contract; progress toward completion of milestones including the number of appeals received during the prior month and the number of appeals resolved; a report of vacant positions and any staff turnover, strategy for completing the work products of the
vacant position, and timeline for filling the position; reporting of medical appeal trends; any policies or work products which require review by TennCare; a listing of any pending items which were previously submitted to TennCare for approval, and other information as requested by TennCare).

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 7 business days, as the statute requires.
Your request will be forwarded to the relevant department(s) to locate the information you seek and to determine the volume and any costs associated with satisfying your request. You will be contacted about the availability and/or provided with copies of the records in question. PLEASE NOTE: The Tennessee Public Records Act does not require a governmental body to create new information, to do legal research, or to answer questions.
You can monitor the progress of your request at the link below and you'll receive an email when your request has been completed. Again, thank you for using the Public Records Portal.
TennCare
To monitor the progress or update this request please log into the Public Records Portal (https://u4037834.ct.sendgrid.net/ls/click?upn=NsSD9AJ7NC1Zn9x435-2BIaOuGAgdXOsA37oC6ARpob6nmebwNsQbxwSybyCP1UvZZQpvYupJ9cXqoAeJdR8jx1rebvvXoZd00nQTrY5FrRJg-3D19zs_IoxAM6mr-2F-2FvfG-2FGWXY47zDaWVdtttFJqF4IQ6XScAXGP78ItTt9OhRslgNYhfvY4StG4-2FKCGUPYR2GsHpdHtuRJicaNXozlZFZr3kvArlK3YjuI5mWzT8VbAp8li7bNHJ657WAieDOe-2BeOg56TaaFF2kxveNT-2FJB3b5XYwcIQ0pF3MgWjf-2B6a7NfYP64d2gxGE412gJSfVIZwGtcHcCU47TeMQPCXkDclW9c4mNtOf1Xr4rZe1UiajdJzZSH6xAV)

--- Please respond above this line ---

April 06, 2020
Kent Hoover
1199 Street Road
Kingston Springs, TN 37082
RE: Records Request of April 01, 2020, Reference # R000150-040120
Dear Kent Hoover,
TennCare received your records request on April 01, 2020. Your request mentioned: “To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

Related to the TennCare Member Appeals Process solicitation (RFP # 31865-00350), which was awarded on or about October 4, 2012. Specifically, I seek the following records:
1. The winning proposal (cost and technical);
2. All competitor proposals (cost and technical);
3. All award evaluations and evaluator notes;
4. Invoices from 2016 to present; and
5. Compliance reports from 2016 to present (including monthly reports that list timelines for all current and future work products to be submitted under this contract; progress toward completion of milestones including the number of appeals received during the prior month and the number of appeals resolved; a report of vacant positions and any staff turnover, strategy for completing the work products of the
vacant position, and timeline for filling the position; reporting of medical appeal trends; any policies or work products which require review by TennCare; a listing of any pending items which were previously submitted to TennCare for approval, and other information as requested by TennCare).

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 7 business days, as the statute requires.”
This letter is to clarify the records you are requesting from the Division of TennCare. Please provide proof of Tennessee citizenship.
If you would like for TennCare to proceed with your information request, please provide clarifications within seven (7) days from 04/06/2020. Otherwise, we will consider your request withdrawn.
You may provide a response to TennCare by any of the following methods:
* By responding to this email; or
* By regular mail to: TennCare Privacy and Public Records Office, 310 Great Circle Road, Nashville, TN 37243.
Upon receipt of your clarification,Tenncare will further process your request as required by law, including if appropriate an estimate of costs associated with producing the requested records.
If you have any questions, please feel free to reply to this email communication or call us at 615-507-6820. Thank you for your attention.
Sincerely,
Andrei Dumitrescu
Public Records Coordinator
Division of TennCare
To monitor the progress or update this request please log into the Public Records Portal (https://u4037834.ct.sendgrid.net/ls/click?upn=NsSD9AJ7NC1Zn9x435-2BIaOuGAgdXOsA37oC6ARpob6kDksC0aP7TkJhWiJLjcuk9mt9fR2aflOvbZBUy5vJm88OUL4MJVWuwJOhE2aRTzIM-3DwEWn_IoxAM6mr-2F-2FvfG-2FGWXY47zDaWVdtttFJqF4IQ6XScAXGP78ItTt9OhRslgNYhfvY4D0IvoQQnq1-2FENP7l6BVtcvB26OXZi4KIdief-2BqBGtCxmRMVHLrQUV38Ve76tJW4pQ2mfIBLOx8NIIsIhiMM6amO-2FUudDUDujTuQGpcdoTkEUsR1-2FBRjdzXjXFCF4DGrU3bdqOHoF3B35B-2FefUQctL1aWXaNhmSQ0HSGkNWPDbdaVBd4DWkQQlkGRXHYxrg3-2F)

--- Please respond above this line ---

October 15, 2020
Kent Hoover
1199 Street Road
Kingston Springs, TN 37082
RE: Records Request of April 01, 2020., Reference # R000150-040120.
Dear Kent Hoover,
On April 01, 2020, you submitted a records request to the Division of TennCare . Your request mentioned: "To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

To Whom It May Concern:

Pursuant to the Tennessee Public Records Act, I hereby request the following records:

Related to the TennCare Member Appeals Process solicitation (RFP # 31865-00350), which was awarded on or about October 4, 2012. Specifically, I seek the following records:
1. The winning proposal (cost and technical);
2. All competitor proposals (cost and technical);
3. All award evaluations and evaluator notes;
4. Invoices from 2016 to present; and
5. Compliance reports from 2016 to present (including monthly reports that list timelines for all current and future work products to be submitted under this contract; progress toward completion of milestones including the number of appeals received during the prior month and the number of appeals resolved; a report of vacant positions and any staff turnover, strategy for completing the work products of the
vacant position, and timeline for filling the position; reporting of medical appeal trends; any policies or work products which require review by TennCare; a listing of any pending items which were previously submitted to TennCare for approval, and other information as requested by TennCare).

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 7 business days, as the statute requires."
Your request has been evaluated and has been denied based on availability of resources and competing agency priorities. Tenn. Code Ann. § 10-7-503(a)(2)(A) provides that “[a]ll state, county and municipal records shall, at all times during business hours . . . be open for personal inspection by any citizen of this state, and those in charge of the records shall not refuse such right of inspection to any citizen, unless otherwise provided by state law.”  Emphasis added. Given that the state statute, as written, does not affirmatively require production of public records to non-citizens, TennCare declines to fulfill your request. Thank you for your interest in the Division of TennCare; however, we respectfully deny your request.
Sincerely,
Andrei Dumitrescu
Public Records Coordinator
Division of TennCare
To monitor the progress or update this request please log into the Public Records Portal (https://u4037834.ct.sendgrid.net/ls/click?upn=NsSD9AJ7NC1Zn9x435-2BIaOuGAgdXOsA37oC6ARpob6kDksC0aP7TkJhWiJLjcuk9mt9fR2aflOvbZBUy5vJm88OUL4MJVWuwJOhE2aRTzIM-3D5eYM_IoxAM6mr-2F-2FvfG-2FGWXY47zDaWVdtttFJqF4IQ6XScAXGP78ItTt9OhRslgNYhfvY4habuC-2Bdmjup70XvXmOd1dLcP-2BTjPUoYnNqK9tHmmiDrDAlNgkt7fzLglg-2FpC6CHBm6hXwscGP0xo6zGpgcLJzFNOcfeBsmJ7tYCpVJpY1txJ-2FOFVuhp0ZcWxB47qe6S9H2qDEM6cFkY44fGKpyMtbbWuxFMTmOocvxsE-2F1vAPWwNVss8d62T4vjl9YVmkXQg)