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Provider Network Directory

Easy-To-Use Guide for All Blue Networks

How To Use This Directory

This directory lists the names of doctors, hospitals, pharmacies and other health care providers that participate in one, some, or all of the provider networks offered by BlueCross BlueShield of Tennessee. The networks are:

?Blue Network P ?Blue Network S ?Blue Network K

To receive the highest level of benefits from your PPO plan, make sure the doctor or provider you choose is in your specific Blue Network.

1. Find the name of your network. Typically, it's located on the front of your member ID card.

For Example

2. Check the provider listing. A provider participates only in the specific network ? or networks ? listed by letter after the name.

Doe, John, MD P K 0000 First Street Chattanooga,TN 37000 (000) 000-0000 Provider #: 0000-000

For Example

Smith, Jane, MD P S K 0000 First Street Chattanooga,TN 37000 (000) 000-0000 Provider #: 0000-000

For Example

3. Make sure they match. You save money and keep costs down when you use doctors, hospitals and providers in your specific Blue Network.

Table of Contents

Reference

Important Information ................................................ 2

Facilities................................................................................ 5 Acute Care Hospitals Ambulatory Surgical Facilities Birthing Centers Dialysis Centers Outpatient Medical Diagnostic Centers Skilled Nursing Facilities (SNF)

Rehabilitation .................................................................. 11 Inpatient Rehabilitation Outpatient Rehabilitation Occupational Therapy Physical Therapy Speech Pathology/Speech Therapy

Physicians Physicians and Health Professionals ................... 23

Urgent Care Urgent Care Providers .......................................... 139

Retail Convenient Care Center .............................141

For services in the following categories, reference the provider type shown:

Category

Impacted Teeth and Accidental Injury to Teeth

Reference

These are considered medical conditions. To receive in-network benefits, please search for a surgeon within the "Oral & Maxillofacial Surgery" specialty category.

Ear and Throat Family Physician

See Otolaryngology

See General Practice, Family Practice, Internal Medicine

Independent Lab Supplies

Also see Acute Care Facilities

Also see Durable Medical Equipment Suppliers

Oral Surgery Sleep Disorder

See Oral Maxillofacial Surgery See Acute Care Facilities

Medical Service Suppliers .......................................143 Durable Medical Equipment (DME) Suppliers Home Health Agencies Home Infusion Therapy Suppliers Hospice Agencies Prosthetic and Orthotic Suppliers Specialty DME Supplies

Independent Laboratories ......................................163

Behavioral Health Providers ..................................165 Mental Health & Substance Abuse Treatment Professionals Behavioral Health Facilities & Programs

Pharmacies .....................................................................189

Index ...................................................................................203

Para la ayuda del cliente en espa?ol, marque por favor 1-866-636-0164.

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Important Information

What is a provider network?

A provider network is a distinct group of doctors, hospitals and other health care providers who have contracted with BlueCross BlueShield of Tennessee. The network includes physicians, health care practitioners, rehabilitation facilities, skilled nursing facilities, durable medical equipment suppliers, independent labs, hospice, home health agencies and other participating providers in Tennessee and some bordering counties.

Network providers are committed to holding down costs while maintaining an appropriate level of quality care. They have agreed to follow medical management guidelines that encourage the use of appropriate alternatives to costly inpatient hospitalization.

In addition, these providers have agreed not to bill you for services that are deemed to be nonmedically necessary, inpatient services and certain outpatient services that are not authorized prior to admission, or any amounts above BlueCross BlueShield of Tennessee's maximum allowable charge, other than member coinsurance, deductibles and copayments.

Finally, network providers have agreed to accept discounted fees for their services. Such discounts not only enable your health plan to cover a larger portion of the claims providers submit ? but they are also reflected in your share of the bill.

health care providers that participate in your plan's specified Blue Network (P, S, or K).

Choosing care from providers who do NOT participate in your plan's Blue Network will result in higher out-of-pocket costs in many ways.

? Reduced Benefits Levels ? you will be required to pay a greater portion of the cost of care received from out-of-network providers, including higher annual deductibles and coinsurance amounts.

? Limited Reimbursements ? reimbursements for out-of-network services are based on the maximum amount that would be paid to an in-network provider for the same service. The maximum amount is referred to as the "maximum allowable charge." Charges that exceed this maximum amount are not covered and are your responsibility. In fact, amounts over the maximum allowable charge do not apply toward your outof-pocket maximum, so there is no limit to your liability for out-of-network services.

? Up-Front Costs ? fees for out-of-network services will be your responsibility until a claim has been submitted and processed. Unlike in-network providers, most out-of-network providers won't file claims for you. You must therefore pay for services up front and then submit the claim yourself.

Finding your provider network

Getting to know your provider network

BlueCross BlueShield of Tennessee has three distinct preferred provider networks, called Blue Networks. Each includes a different grouping of doctors, hospitals and other health care facilities in your area. Your PPO plan includes one Blue Network (either P, S, or K).

Typically, you can locate your health plan's "Blue Network" in the lower left-hand corner or in the upper right-hand corner of your BlueCross BlueShield of Tennessee member ID card. This one-letter distinction (P, S, or K) signifies your PPO plan's specific network of providers.

Your PPO plan entitles you to visit any provider you choose. However, to receive the highest level of benefits from your PPO plan, and to keep your out-of-pocket costs to a minimum, it is best to choose care from doctors, hospitals and other

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If you are a member of a BlueCross BlueShield health plan other than BlueCross BlueShield of Tennessee, then simply choose providers from the Blue Network that matches your BlueCard network distinction.

Using a provider network

Here are some tips to consider when visiting a BlueCross BlueShield of Tennessee network provider.

Finding a provider in your network

To find a doctor, hospital or other health care provider using this directory, simply:

? Turn to the appropriate provider section

(Facilities, Rehabilitation, Physicians, Medical Service Suppliers, Independent Laboratories, Behavioral Health Providers, or Pharmacies), or look up your provider by name in the Index.

? Depending on the section, providers are

listed alphabetically by various criteria such as specialty, county, facility type and provider name.

? When a desired provider is located, look to the

right of the provider's name to find out if the provider participates in your plan's Blue Network (P, S, or K).

? Providers are added to networks daily, so it

is important to check and see if a provider participates in your plan's Blue Network before accepting services from them.

? For the most up-to-date listing of providers, visit

and click on the Find A Doctor tool.

Finding a provider with BlueCard

If you are a member of a BlueCross BlueShield health plan other than BlueCross BlueShield of Tennessee, then simply choose providers from the Blue Network that matches your BlueCard network distinction.

? Present your BlueCross BlueShield of Tennessee

member ID card each time you request services from a network provider. Your member ID card includes helpful information such as copay amounts, if applicable, and your plan's network distinction.

? Before requesting services from any health care

provider, make sure the provider participates in your provider network. Be specific when asking a provider if they participate in your health plan's provider network. Simply asking, "Do you accept BlueCross BlueShield of Tennessee insurance?" is not specific enough. Be sure to ask if your provider participates in your plan's particular provider network (for example,"Blue Network P").Your plan's network distinction (P, S, or K) can be found beside the heading"Blue Network:" on your BlueCross BlueShield of Tennessee member ID card.

? Accepting services from providers that do not

participate in your plan's particular provider network will result in higher out-of-pocket costs.

? Do not assume that your doctor will only refer

you to specialists, hospitals and/or other health care providers that participate in your plan's provider network. Make sure that all referred providers participate in your plan's provider network before accepting services from them.

? Call 1-800-810-BLUE if you are outside of

Tennessee to find a network provider. This number will be on the back of your member ID card.

? Emergency care is covered anytime, anywhere.*

Simply present your BlueCross BlueShield of Tennessee member ID card when arriving at an emergency room. Then be sure that you or a family member calls member service within 24 hours if you are admitted to the hospital.

Blue Network P

Blue Network P

* Unless you have reached your lifetime benefit maximum with BlueCross BlueShield of Tennessee.

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Please consider...

? All information listed in this directory is subject

to change.

? The information is this directory was current at

the time of printing. Changes to Blue Networks happen daily. For the most current listing of providers, visit .

? Make sure your provider currently belongs

to your plan's particular Blue Network before accepting services from your provider.

? For complete administrative and benefit

information about your particular health plan, please consult your Evidence of Coverage (EOC) or policy.

? BlueCross BlueShield of Tennessee does not

provide or endorse services from participating providers, nor guarantee a provider's quality of service. Listing in this directory does not mean that BlueCross BlueShield of Tennessee and participating providers are: employer and employee; principal and agent; or any relation other than that of independent parties.

Pharmacy

Check your Evidence of Coverage (EOC) or policy to determine if pharmacy benefits are covered under your health plan. If you are a member of a BlueCross BlueShield health plan other than BlueCross BlueShield of Tennessee, this pharmacy information does not apply.

Participating pharmacies belong to a specific network (example: RX04). To receive the highest level of benefits from your pharmacy plan, choose only those pharmacies that participate in your plan's specific pharmacy network. Purchasing prescription drugs from out-of-network pharmacies will result in higher out-of-pocket costs.

To locate your plan's pharmacy network distinction (example: RX04), look on the front of your BlueCross BlueShield of Tennessee member ID card.

Member service you can count on

If you ever have any questions about your plan's Blue Network, please feel free to call BlueCross BlueShield of Tennessee member service at 1-800-565-9140. Or, simply log on to and click on the Find A Doctor tool for the most current listing of providers.

Remember: Provider status is subject to change.

Providers listed in this directory are verifiable only up to the time the directory was printed.

About Blue Network K

Blue Network K was built around medical centers in major metropolitan areas. Blue Network K includes medical centers and providers throughout the state; however, members in Network K in some areas may be required to travel greater distances to receive in-network care.

To verify that a provider is still participating in your Blue Network, you can: 1. Call the Member Service number on your

member ID card; or

2. Access our Web site, . Click on Health Tools for the Find A Doctor tool, choose the type of provider you need, then select your specific Blue Network.This is updated daily.

For example:

? Blue Network K members who live in rural areas

of middle Tennessee may be required to travel to Nashville to receive in-network care.

? Blue Network K may only include certain highly

specialized providers in one urban center, requiring a member to travel from Chattanooga to Nashville.

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Facilities

Many Acute Care Facilities also provide Independent Laboratory, Rehabilitation and Sleep Disorder Services. Inpatient care for mental health and substance abuse treatment will be provided through a special network. Please refer to the Behavioral Health Providers section for a listing of practitioners in the network. Remember: Provider status is subject to change. Providers listed in this directory are verifiable only up to the time the directory was printed. To verify that a provider is still participating in your Blue Network you can: 1. Call the Member Service number on your ID card;

or 2. Access our Web site, . Click on the

Find A Doctor tool, choose the type of provider you need, then select your specific Blue Network. This is updated daily.

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Acute Care Hospital

Networks

Acute Care Hospital

Anderson County

Methodist Med Ctr of Oak Ridge

Avery County (NC)

Charles A Cannon Jr Memorial Hospital

Bedford County

Heritage Medical Center

Benton County

Camden General Hospital

Bledsoe County

Erlanger Bledsoe

Blount County

Blount Memorial Hospital

Bradley County

Skyridge Medical Center

Calloway County (KY)

Murray Calloway County Hospital

Campbell County

St Marys Med Ctr of Campbell County

Cannon County

Stones River Hospital

Carroll County

Baptist Memorial Hospital Huntingdon McKenzie Regional Hospital

Carter County

Sycamore Shoals Hospital

Catoosa County (GA)

Hutcheson Medical Center

Cheatham County

Centennial Med Ctr at Ashland City

Claiborne County

Claiborne County Hospital

Clay County

Cumberland River Hospital

Clinton County (KY)

Clinton County Hospital

Cocke County

Baptist Hospital of Cocke Co

Coffee County

Harton Regional Medical Center Medical Center of Manchester United Regional Medical Center

Crittenden County (AR)

Crittenden Regional Hospital

Cumberland County

Cumberland Medical Center

Cumberland County (KY)

Cumberland County Hospital

Davidson County

Baptist Hospital Inc Centennial Medical Center Metropolitan Nash General Hosp Saint Thomas Hospital Select Specialty Hospital Nashville Skyline Medical Center Southern Hills Medical Center Summit Medical Center The Center for Spinal Surgery Vanderbilt Childrens Hosp

PS

P

PSK

PS

PSK

PS

PSK

PS

PS

PS

PS PS

PS

PS

P

PSK

PSK

P

PSK

PS PS PS

P

PS

P

PS P PS PS PS P P P PS PSK

S-Network S P-Network P K-Network K

Networks

Networks

Vanderbilt Univ Medical Center

Decatur County

Decatur County General Hosp

DeKalb County

Dekalb Community Hospital

DeSoto County (MS)

Baptist Memorial Hospital Desoto

Dickson County

Horizon Medical Center

Dyer County

Dyersburg Regional Medical Center

Fayette County

Methodist Hospital of Fayette

Fentress County

Jamestown Regional Medical Center

Franklin County

Southern Tennessee Medical Center

Fulton County (KY)

Parkway Regional Hospital

Gibson County

Gibson General Hospital Humboldt General Hospital Milan General Hospital

Giles County

Hillside Hospital

Graves County (KY)

Jackson Purchase Medical Center

Greene County

Laughlin Memorial Hospital Inc Takoma Regional Hospital

Hamblen County

Lakeway Regional Hospital Morristown Hamblen Hosp Assoc Inc

Hamilton County

Erlanger East Erlanger Medical Center Erlanger North Kindred Hospital Chattanooga Memorial Hospital Memorial North Park Hospital Miller Eye Center Parkridge East Hospital Parkridge Medical Center T C Thompson Childrens Hosp

Hancock County

Wellmont Hancock County Hospital

Hardeman County

Bolivar General Hospital

Hardin County

Hardin Medical Center

Hawkins County

Hawkins County Memorial Hospital

Haywood County

Haywood Park Community Hospital

Henderson County

Henderson County Community Hospital

Henry County

Henry County Medical Center

Hickman County

Hickman Community Hospital

PSK

PS

PS

PS

P

PS

P

PS

PS

PS

PS PS PS

PS

P

PS PS

PSK PS

PSK PSK PSK PS P P PSK PS PS PSK

PS

PS

PS

PS

PS

PS

PS

PS

Houston County

Patients Choice Med Center of Erin TN LLC P S

Humphreys County

Three Rivers Hospital

PS

Jefferson County

Jefferson Memorial Hosp Inc

PS

Johnson County

Johnson County Community Hospital

PS

Knox County

Baptist Hospital for Women East Tenn Childrens Hosp Fort Sanders Regional Med Ctr Mercy Medical Center Mercy Medical Center West Parkwest Medical Center Select Specialty Hospital Knoxville Select Specialty Hospital North Knoxville University of Tennessee Medical Center

PK PSK PS P PK PS PS PS PSK

Lauderdale County

Baptist Mem Hosp Lauderdale

PS

Lawrence County

Crockett Hospital

PS

Lincoln County

Lincoln Medical Center

PS

Loudon County

Fort Loudoun Medical Center

PS

Macon County

Macon County General Hosp

PSK

Madison County

Jackson Madison Co Gen Hosp

PS

Marion County

Grandview Medical Center

PS

Marshall County

Marshall Medical Center

PS

Maury County

Maury Regional Hospital

PS

McMinn County

Athens Regional Medical Center

PS

Woods Memorial Hospital

P

McNairy County

McNairy Regional Hospital

PS

Monroe County

Sweetwater Hospital Assoc

PS

Monroe County (KY)

Monroe County Medical Center

PS

Montgomery County

Gateway Medical Center

PS

Patients Choice Med Center of Erin TN LLC P S

Vanderbilt Childrens Hosp

PSK

Obion County

Baptist Mem Hosp Union City

PS

Overton County

Livingston Regional Hosp

PS

Perry County

Perry Community Hospital

PS

Polk County

Copper Basin Medical Center

PS

Putnam County

Cookeville Regional Medical Center

PS

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Check our Web site @ for current listing.

Facilities

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