Toll-Free Customer Service Line 1-877-296-6189
Mail Provider Enrollment Applications to:
Riverbend Government Benefits Administrator
ATTN: Provider Enrollment-3C
730 Chestnut Street
Chattanooga, TN 37402
If you are located in the states of CA, DC, HA, ID, IL, IN, IA, MA, MI, MN, MT, NE, NJ, NY, ND, OH, OR, PA, SD, VA, WA, WV, WI, or WY, and have questions regarding the Form CMS 855A contact:
Julietta Jones, Enrollment Auditor
(423) 535-5124
If you are located in the states of AL, AK, AZ, AR, CO, CT, FL, GA, KS, KY, LA, ME, MD, MS, MO, NV, VH, NM, NC, OK, RI, SC, TN, TX, UT, or VT, and have questions regarding the Form CMS 855A contact:
Trina Roberts, Enrollment Auditor
(423) 535-3823