RS2026-2274: A resolution approving a provider participation agreement between the Metropolitan Government of Nashville and Davidson County, acting by and through the Metropolitan Board of Health, and Renaissance Life and Health Insurance Company of America, to allow the Metropolitan Government to participate in provider networks and receive payment for services provided to individuals enrolled in a TennCare Dental Benefits Management Program.

Description

A resolution approving a provider participation agreement between the Metropolitan Government of Nashville and Davidson County, acting by and through the Metropolitan Board of Health, and Renaissance Life and Health Insurance Company of America, to allow the Metropolitan Government to participate in provider networks and receive payment for services provided to individuals enrolled in a TennCare Dental Benefits Management Program.

Summary

Abacus Matter 26-0453 authorizes Nashville’s Metropolitan Public Health Department to join Renaissance’s TennCare dental provider network. The 60-month agreement covers TennCare children, adults, CoverKids, ECF CHOICES, and 1915(c) enrollees. The Department must provide medically necessary, nondiscriminatory dental care; meet licensing, accessibility, EPSDT, credentialing, claims, recordkeeping, and fraud-prevention requirements; and support patient appeals and quality reviews. Renaissance will administer benefits, maintain provider listings, process claims, set fee schedules, and oversee quality. The agreement matters because it expands coordinated access to covered dental services for eligible Nashville residents while allowing state and federal audits and preserving Tennessee Public Records Act obligations.