INSURER FILING GUIDE
State of Tennessee ParTNers for Health, behavioral benefit (Optum administered as published)
Use this public information to prepare your packet, then confirm the route on the insurer's own page.
AT A GLANCE
Claim facts
| Member form | UNREADABLE: out-of-network claim form in the Live and Work Well forms area Number: UNREADABLE Revision: UNREADABLE |
|---|---|
| Portal upload | YES |
| Portal path | Here4TN Member Benefits > Access important forms > out-of-network claims > get more information and submit your out-of-network claim |
| Mail address | Claims processing, PO Box 30755, Salt Lake City, UT 84130-0755 |
| Fax | Not published by the insurer |
| Attachments | Not published by the insurer: login-gated form fields and attachment instructions are UNREADABLE |
| Deadline | Within 13 months of the date the claim was incurred |
| Outcome and status | Here4TN > Manage Claims; select Account Balance for cost-share information; login required |
| Processing time | Not published by the insurer |
| Caveats | Routine out-of-network outpatient mental health care does not require a referral; non-routine outpatient and facility services require prior authorization; this is not the separate UMR Tennessee Plan |
STEP BY STEP
Filing steps
Source: https://www.liveandworkwell.com/?pin=here4tn&redirectURL=/content/en/member/forms.html
Read date: 10-09-2026
Research steps
- Use the Optum behavioral route linked from Here4TN. On Member Benefits, open Access important forms, then the out-of-network claim link. It leads to the login-gated Live and Work Well forms area. Here4TN member benefits
- Portal upload YES. Here4TN says a member using a non-network provider needs to submit the claim and links to a route to get information and submit it. UNREADABLE: the form, post-login menu, file types, limits, document grouping, confirmation, signature rules, itemized-bill requirements, and payment recipient. Here4TN member benefits Live and Work Well forms
- File within 13 months after the claim was incurred. Proof must be in a format acceptable to the third-party administrator. State Plan Description
- Check claim information in Here4TN under Manage Claims. Select Account Balance for published cost-share information. Login is required. NOT PUBLISHED: processing time. Here4TN member benefits
- Routine out-of-network outpatient mental health care does not require a referral. Non-routine outpatient and facility services require prior authorization. ParTNers behavioral health
Filing facts
- Portal upload: YES
- Portal: Here4TN and Live and Work Well
- Portal path: Here4TN Member Benefits > Access important forms > out-of-network claims > get more information and submit your out-of-network claim
- Mail address: Claims processing, PO Box 30755, Salt Lake City, UT 84130-0755
- Fax: NOT PUBLISHED
- Attach: NOT PUBLISHED: login-gated form fields and attachment instructions are UNREADABLE
- File types: UNREADABLE
- File size limit: UNREADABLE
- Maximum files: UNREADABLE
- One file or separate files: UNREADABLE
- Confirmation: UNREADABLE
- Status check: Here4TN > Manage Claims; select Account Balance for cost-share information; login required
- Processing time: NOT PUBLISHED
- Member deadline: Within 13 months of the date the claim was incurred
- Deadline basis: The State, local education, and local government plan documents control; proof must use a format acceptable to the TPA
- Mental health route: Optum Behavioral Health administers the behavioral benefit; Here4TN links to the Live and Work Well claim route
Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.
Read on 10-09-2026 from https://www.liveandworkwell.com/?pin=here4tn&redirectURL=/content/en/member/forms.html;https://www.liveandworkwell.com/en/member/here4tn/help-center/forms. Confirm the address, fax number or portal path on the insurer's own claims page before you send.