Appendix%207.3%20Provider%20Disruption%20Analysis%20Instructions%20and%20Template.xlsx

This file is a Provider Disruption Analysis Template and Instructions document for Tennessee's state health plans Third Party Administrator (TPA) Services contract, containing a comprehensive listing of healthcare providers across multiple specialties currently utilized in the state's efficient network. The document serves as an appendix requiring bidders to identify whether each listed provider will be included in their proposed Tennessee efficient network for the contract term. The template consists of two tables: Table 1 lists individual providers by National Provider Identifier (NPI), name, location, state, zip code, provider type, and claim/patient statistics, while Table 2 requires bidders to summarize network composition by calculating the total number of providers, percentage of providers, percentage of claimants, and percentage of claims categorized as either in-network or out-of-network, organized by provider type excluding facilities. The provider data spans multiple medical specialties including Acupuncturists, Allergy & Immunology physicians, Cardiovascular Disease/Cardiology specialists, Case Managers, and Chiropractors/Designated Care Managers, with hundreds of providers listed across Tennessee's various regions.

The template captures current utilization patterns showing significant variation in provider utilization by specialty and geographic location, with some providers managing substantial patient volumes while others serve minimal caseloads. Providers are distributed throughout Tennessee including major metropolitan areas such as Nashville, Memphis, Knoxville, and Chattanooga, as well as smaller communities across the state. The document requires bidders to indicate network participation status for each provider, enabling the state to assess proposed network continuity and identify potential service disruption risks during any transition to a new TPA. This analysis tool is essential for evaluating bidder proposals and ensuring adequate provider network maintenance to protect beneficiary access to healthcare services across all regions and specialties represented in the current network.