When a TennCare dental referral goes nowhere: what to do, step by step
Your dentist says you need an oral surgeon, a root canal specialist, or treatment under sedation, and hands you a referral. Then the office on the list doesn't take TennCare, doesn't answer, or offers an appointment months away. This happens often enough that TennCare members raised it with the state directly. Here's the escalation path, from a phone call to a formal appeal.
Call Renaissance at 866-864-2526 and ask them to find you an in-network specialist who can actually see you; write down who you talked to and what they said. If that doesn't work, you can file a TennCare medical appeal: TennCare's appeal form has a box for “I am waiting too long to get care or medicine.” Call 1-800-878-3192, and do it within 60 days of finding out about the problem. If waiting could seriously harm your health, ask for an expedited appeal (decided in about a week). The Tennessee Justice Center (615-255-0331) helps with TennCare appeals for free.
How this page works: the appeal rights, deadlines, and phone numbers come from TennCare's own appeal page and appeal form. The problems described come from TennCare's January 2026 Beneficiary Advisory Council minutes, where members reported them directly to TennCare staff; we label them as member-reported. TennCare doesn't publish dental appointment wait-time standards on its public pages, so we don't quote one.
Why referrals fail
A general dentist refers out when the work needs a specialist: a difficult extraction, a complex root canal, gum surgery, or treatment that needs deeper sedation or a hospital setting. Under TennCare, the specialist also has to be in the Renaissance network. That's where things break down.
“Listed” isn't the same as “seeing patients”
At TennCare's January 2026 Beneficiary Advisory Council meeting, members reported specialists listed as accepting TennCare who then wouldn't see them. A directory listing can be out of date, or the office may have stopped taking new TennCare patients.
Long waits
Members at the same meeting reported new-patient waits of three to four months for adults. That's member-reported, not a measured average, but it matches what we hear. Adult dental coverage only began in 2023, and fewer offices take adults than children.
The 2025 switch to Renaissance
Renaissance took over all TennCare dental benefits on November 1, 2025. A referral written before then may point to an office that isn't in the new network. Ask Renaissance to check.
Sedation and hospital cases
Patients who need treatment under general anesthesia (young children, people with disabilities, very extensive work) depend on a small number of providers. Waits for these cases tend to be the longest. See our special-needs dental care guide.
What to do, step by step
Work down the list. Most problems are fixed at step 2 or 3; the appeal is there when they aren't.
- Get the referral details in writing. Ask your dentist's office for the specialist type, the procedure (and procedure code, if they have it), the tooth numbers, and how soon it should be done. “Within two weeks” and “sometime this year” lead to very different conversations.
- Call the specialist and ask the exact question. “Are you in the Renaissance network for TennCare [adult or child] dental, and are you taking new patients?” If the answer is no, you've saved a trip.
- Call Renaissance: 866-864-2526 (7 a.m.–5 p.m. Central; TTY 711). Tell them the specialist on your referral can't see you, and ask them to find an in-network specialist who can, with an appointment in a reasonable time. Ask for more than one name. You can request an interpreter.
- Ask your dentist to help. Offices that refer often know which specialists are actually taking TennCare patients. Ask whether part of the work can be done in-house, or whether there's a covered alternative.
- Need a ride? Book it early. TennCare's non-emergency transportation covers trips to covered dental appointments. Book at least two business days ahead; urgent appointments are verified with the dental office.
- If you're still stuck, file an appeal. See the next sections. Keep your log; it's your evidence.
Keep a log from the first call
An appeal goes better with dates and names than with “I've been calling for months.” A notebook or a note on your phone is fine.
| Write down | Example |
|---|---|
| Date and time | Oct. 6, 10:15 a.m. |
| Who you called | Renaissance member services; or the specialist office's name and number |
| Who you talked to | First name, and any reference or call number they give you |
| What they said | “Not taking new TennCare adults”; “earliest new-patient opening is February” |
| What happens next | “Renaissance will call back with two names by Friday” |
Also keep copies of the referral, any letters from Renaissance or TennCare, and anything your dentist writes about how urgent the treatment is.
Filing a TennCare medical appeal
An appeal isn't only for a flat denial. TennCare's medical appeal form lists the problems you can appeal, and several fit a failed referral.
| Box on the form | When it fits |
|---|---|
| “I am waiting too long to get care or medicine.” | You have a referral, but no in-network specialist can see you in a reasonable time. |
| “I can't get this care or medicine at all.” | No in-network provider will take you, or treatment was refused. |
| “I can't get as much of this care or medicine as I need.” | Only part of the treatment was approved. |
| “My care or medicine is being cut or has ended.” | Treatment you were getting was stopped. |
| “I have medical bills for care or medicine that TennCare should pay for.” | You were billed for covered dental care. |
01 The deadline
TennCare says you have 60 days to appeal “after you find out that there is a problem.” Don't wait for the 60th day; start when it's clear the referral isn't working.
02 How to file
Phone: TennCare Member Medical Appeals, 1-800-878-3192 (free; you can appeal by phone). Fax: 1-888-345-5575 (keep the page showing it went through). Mail: TennCare Member Medical Appeals, P.O. Box 593, Nashville, TN 37202-0593. Email: TMMA.Contact.Center@tn.gov. The form is available in English and Spanish; keep a copy of whatever you send.
03 What to say
Name the treatment you need, who referred you, the specialists you tried, and what each said, using your log. Say how the delay is affecting you: pain, infection, trouble eating, missed work. Attach your dentist's note about urgency if you have one.
04 How long it takes
TennCare says appeals are usually decided within 90 days of filing. Expedited appeals are faster (see below). If you're already getting care that's being cut or stopped, the form asks whether you want to keep getting it during the appeal; TennCare warns that if you do and you lose, you may have to pay TennCare back.
Free help with your appeal
The Tennessee Justice Center, a nonprofit in Nashville, helps people with TennCare and CoverKids enrollment and appeals. Call 615-255-0331 or use the case inquiry form on tnjustice.org. For questions about TennCare's medical coverage more broadly, see TN Health Coverage Explained.
If it's urgent
Some dental problems can't wait 90 days. TennCare's appeal process has a faster track, and some situations belong in the emergency room today.
Expedited appeal: about one week
If waiting 90 days could “put your life or physical or mental health in real danger,” ask for an expedited appeal when you call 1-800-878-3192. If TennCare and your plan agree it's an emergency, it's decided in about a week (longer if records are needed).
Your dentist can ask for you
A provider can request an expedited appeal on your behalf, but you must give written permission first: a note with your name, date of birth, the provider's name, and that you give permission. The provider completes TennCare's “Treating Provider's Certificate” form and can send it with your records.
Go to the ER now if…
Swelling in your face is spreading toward your eye or neck, you have trouble breathing or swallowing, or you have a fever with facial swelling. These can be signs of a spreading infection. The ER can't fix the tooth, but it can treat the emergency.
After hours
Renaissance's TeleDentistry service is included with TennCare dental coverage and can help with after-hours problems and finding in-network care.
Getting care while you wait
These don't replace the specialist, but they can relieve pain, treat infection, or sometimes do the work themselves. Most accept TennCare; call first.
- County health department dental clinics. The Tennessee Department of Health ran 33 staffed dental clinics in local health departments in FY2025, mostly rural, and most accept TennCare. Services vary by county.
- Community health centers (FQHCs). Many have dental clinics and accept TennCare. Find one at findahealthcenter.hrsa.gov.
- Dental school clinics. UTHSC in Memphis and Meharry in Nashville have specialty and residency clinics. UTHSC's Special Care Clinic lists TennCare among the insurance it accepts. Ask whether they take your TennCare plan for the treatment you need. See our low-cost care guide for numbers.
- Cancellation lists. Ask every specialist office that does take TennCare to put you on its short-notice list.
For children
Children on TennCare (under 21) are covered under Medicaid's children's checkup and treatment rules (EPSDT), which include treatment that's medically necessary, not just checkups. CoverKids covers children under 19. The same steps apply: call Renaissance, keep a log, and appeal if care is delayed. If your child needs treatment under sedation, ask Renaissance specifically for pediatric dentists or oral surgeons who provide it, since those referrals tend to take longest. Our kids' dental guide covers sedation questions to ask.
Questions people actually ask us
In the words patients use — because the worry behind the question is usually the real question.
Call Renaissance, TennCare's dental benefits manager, at 866-864-2526 and ask them to find an in-network specialist who is taking new TennCare patients and can see you in a reasonable time. Ask for more than one name, and write down who you spoke to and what they said. If that doesn't work, you can file a TennCare medical appeal.
Yes. TennCare's medical appeal form includes the option "I am waiting too long to get care or medicine." Call TennCare Member Medical Appeals at 1-800-878-3192, or send the form by fax, mail, or email. File within 60 days after you find out there's a problem.
TennCare says appeals are usually decided within 90 days after you file. An expedited appeal, for cases where waiting could put your life or physical or mental health in real danger, is usually decided in about one week if TennCare and your plan agree it's an emergency.
A provider can request an expedited appeal for you, but you must first give written permission with your name, date of birth, the provider's name, and a statement that you give permission. The provider then completes TennCare's Treating Provider's Certificate form.
The Tennessee Justice Center, a nonprofit in Nashville, helps people with TennCare and CoverKids appeals. Call 615-255-0331 or use the case inquiry form on its website. TennCare also offers free language help and disability accommodations.
Only for emergencies: facial swelling spreading toward the eye or neck, trouble breathing or swallowing, or fever with swelling. The ER can treat a spreading infection or severe pain but usually can't fix the tooth. For other problems, call Renaissance, use its TeleDentistry service, or try a health department or community health center dental clinic.
Adult TennCare dental coverage started in 2023, and fewer offices take adults than children. At TennCare's January 2026 advisory council meeting, members reported specialists who were listed as accepting TennCare but wouldn't see them, and new-patient waits of three to four months. Cases needing sedation or hospital treatment tend to wait longest.
Sources & method
- TennCare — How to File a Medical Appeal — tn.gov: 60-day deadline, phone, fax, mail, and email, English and Spanish forms, 90-day standard decisions, expedited appeals in about one week, the “real danger” standard, provider requests with written permission, and free language help.
- TennCare Medical Appeal Form — tn.gov PDF: the list of problems you can appeal (including “I am waiting too long to get care or medicine”), keeping care during an appeal, and the pay-back warning.
- TennCare Beneficiary Advisory Council minutes, January 2026 — tn.gov PDF: member-reported specialist availability problems, 3–4 month new-patient waits, ER use, and teledentistry awareness.
- TennCare — Dental Services — tn.gov: Renaissance phone and hours, changing dentists, TeleDentistry, and transportation booking. TennCare — Dental Providers — tn.gov: Renaissance start date (November 1, 2025).
- Tennessee Justice Center — Contact — tnjustice.org: phone and help with TennCare and CoverKids appeals.
- UTHSC College of Dentistry — Special Care Clinic — uthsc.edu: insurance accepted, including TennCare. Tennessee Department of Health, Oral Health Services Annual Report FY2025 — PDF: 33 health department dental clinics.
Method in one line: every appeal right, deadline, and phone number comes from TennCare's own appeal page and form; member experiences are labeled as member-reported; and we don't quote wait-time standards TennCare doesn't publish.