Working With Providers

Collaboration

We’ve recently rolled out several changes in collaboration with our provider partners that help us ensure affordable care for our members. 

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Collaboration efforts

Learn more about how we're working with providers to reduce costs and improve access to care, including:

Total joint replacement bundle

Alongside Tennessee Orthopaedic Alliance (TOA), we launched a program with Ascension Saint Thomas to lower costs related to planned total joint replacement surgery and to make it easier for eligible BlueCross members in Middle Tennessee to understand and plan for their part of those costs. 

The new “bundle” tightly coordinates care and streamlines claims and pricing for members covered by plans in Blue Networks P and S whose cases meet clinical  guidelines established by BlueCross and TOA providers.  

Expanding Network E 

Marketplace Network E offers our most affordable plans with access to trusted regional health systems. It now includes the Tennessee facilities and providers of the Ballad Health system and Cookeville Regional Medical Center, in addition to: 

  • •Erlanger Health in Chattanooga
  • •UT Medical Center in Knoxville
  • •Ascension Saint Thomas in West Central and Middle Tennessee
  • •Baptist Memorial Health Care in Memphis and West Tennessee

Blue Network E includes $0 virtual care, mental health support, diabetes management tools and rewards for healthy behaviors. With Blue Network E available, members can explore cost savings that still offer access to quality care. 

Streamlining prior authorizations 

We use prior authorization to help ensure the care and medications our members receive are safe, clinically appropriate, covered by their plan and cost-effective. We’re joining our fellow Blue plans to make prior authorizations work better for everyone. Learn more about our efforts.