ATTENTION XANTUS PROVIDERS

BEGINNING 8/1/03, ACS EDI GATEWAY WILL CONTINUE TO ACCEPT CLAIMS FOR XANTUS, HOWEVER CLAIMS WITH DATES OF SERVICES OF 8/1/03 THROUGH 10/14/03 WILL BE REJECTED IN THE ACS CLEARINGHOUSE SYSTEM. PROVIDERS WILL NEED TO MAIL CLAIMS WITH DATES OF SERVICES 8/1/03 THROUGH 10/14/03 ON PAPER TO:

 XANTUS
@ P.O. BOX 20170
NASHVILLE, TN 37202

PLEASE BE ADVISED THAT EFFECTIVE MIDNIGHT, 10/14/03 ACS WILL NO LONGER ACCEPT ELECTRONIC CLAIMS FOR XANTUS AND XANTUS CLAIMS WILL NEED TO BE MAILED ON PAPER TO THE ABOVE ADDRESS. IF YOU HAVE ANY QUESTIONS PLEASE CONTACT TENNCARE @ THE TENNCARE HOTLINE (615) 741-4800 OR TOLL FREE (800) 669-1851 OR VISIT THE TENNCARE WEBSITE @ www.state.tn.us/tenncare.

Enrollment Information Sheets & Agreements

EDI Individual, Billing Agent/Group Enrollment Sheet- This form must be completed and returned to ACS by group providers, billing agents, and clearinghouses that will submit claims electronically.

Fax or mail the EDI Information Sheet to:
ACS
2324 Killearn Center Blvd.
Tallahassee, FL 32309
or fax to:
(850) 385-1705