Working with providers

Focused on affordability

BlueCross tried to reach a new agreement with Anesthesia Medical Group (AMG). However, AMG left our commercial networks on April 1, and we know members may have questions and concerns about this change. We’re here to help them understand their options and find in-network providers when they need care.

Latest updates

AMG officially left our commercial networks (P and S) and our BlueCare, TennCareSelect and Dual Special Needs Plan networks on April 1. Since then, we’ve made repeated efforts to reach a fair agreement, but AMG has continued to demand higher rates.

AMG left networks, but we’re protecting members

AMG, the largest anesthesia provider in Middle Tennessee, notified us of their intent to leave our networks if they do not receive a 37% rate increase. Their proposal would drive up premiums and out-of-pocket costs for our members, so we couldn’t say yes. We have a responsibility to keep costs as low as we can, which means AMG will continue to be out-of-network for the foreseeable future.

What members need to know

As always, emergency care is covered as in-network, and BlueCross members experiencing a true emergency should always go to the closest facility.

Now that AMG has left our network, other services would be considered out-of-network. We encourage our members to seek care from in-network providers so they can make the most of their benefits. We’re committed to helping members find providers in their network.

If you have additional questions, please call the Member Service telephone number on the back of your Member ID card for assistance.

Why it matters

AMG is already one of the highest-paid anesthesia practices in the state, and they are asking for rate increases that would total millions more per year. Employers and members can’t afford these higher prices.

The No Surprises Act protects patients from unexpected medical bills, but some providers like AMG are using the Independent Dispute Resolution (IDR) process to get much higher payments than the law intended.

IDR is now a major factor in rising healthcare costs for Tennessee employers, but we’re continuing to advocate for affordability.

This matters because what we pay providers directly impacts what members and employers pay for coverage. Around 91 cents of every premium dollar goes toward paying providers for care.

Frequently Asked Questions

For members

Federal protections under the No Surprises Act may limit what an out-of-network provider can bill you in certain situations—like anesthesiology provided at in-network facilities. The Independent Dispute Resolution (IDR) process is intended to help insurers and providers reach agreement on specific claims to protect patients against unexpected medical bills from out-of-network providers.

Recently, many providers like AMG have been using the IDR process to receive much higher payments than intended. We encourage our members to seek care from in-network providers to avoid rising costs from IDRs. Please call us if you receive a bill that looks incorrect.

AMG providers offer care at the following facilities:

Baptist Ambulatory Surgery Center
Centennial Surgery Center
Clarksville Eye Surgery Center
Franklin Surgery Center
Northridge Surgery Center
Patient Partners Surgery Center
Saint Thomas SC of Clarksville
Southern Joint Surgery Center
Summit Medical Center
Summit Surgery Center
Sumner Regional Medical Center
Surgery Center of Clarksville
Tennova Healthcare Clarksville
TriStar Centennial Medical Center - Nashville
TriStar Hendersonville Hospital
TriStar Horizon Medical Center
TriStar Skyline Medical Center
Tristar Summit Medical Center
Williamson Medical Center

Yes. See below.

Hospital Name	Network P	Network S	BlueCare	TennCare Select	DSNP
American Endoscopy Center	X		X	X	X
Ascension Saint Thomas DeKalb Hospital LLC	X	X	X	X	X
Ascension Saint Thomas Hickman Hospital	X	X	X	X	X
Ascension Saint Thomas Highlands Hospital LLC	X	X	X	X	X
Ascension Saint Thomas Hospital	X	X	X	X	X
Ascension Saint Thomas Hospital for Spinal Surgery	X	X	X	X	X
Ascension Saint Thomas River Park Hospital LLC	X	X	X	X	X
Ascension Saint Thomas Rutherford Hospital	X	X	X	X	X
Ascension Saint Thomas Stones River Hospital LLC	X	X	X	X	X
Ascension Saint Thomas Three Rivers	X	X	X	X	X
Associated Endoscopy	X	X	X	X	X
Baptist Plaza Surgicare	X	X	X	X	X
Bone and Joint Institute of Tennessee Surgery Center	X	X
Brentwood Surgery Center LLC	X	X	X	X	X
Center For Day Surgery Inc.	X	X	X	X	X
Clarksville Surgicenter	X	X	X	X	X
Columbia TN Endoscopy	X	X	X	X	X
Cookeville Regional Medical Center	X	X	X	X	X
Dickson Ambulatory Surgery Center	X	X	X	X	X
Digestive Disease Endoscopy Center Inc.	X	X	X	X	X
Endoscopy Center of Murfreesboro Medical Clinic	X	X
Endoscopy Center of St. Thomas	X	X	X	X	X
Eye Surgery Center of Middle Tennessee	X	X
Eye Surgery Center of Nashville	X	X	X	X	X
GI Specialists of Clarksville PC	X	X
Green Surgery Center	X	X	X	X	X
Gurley Surgery Center	X	X
Indian Lake Surgery Center	X	X
Lebanon Endoscopy Center LLC	X	X	X	X	X
Lincoln Medical Center	X	X	X	X	X
Macon County General Hospital	X	X	X	X	X
Marshall Medical Center	X	X	X	X	X
Maury Regional Medical Center	X	X	X	X	X
Medical Parkway Surgery Center	X	X	X	X	X
Mid State Endoscopy Center LLC	X	X	X	X	X
Middle Tennessee Ambulatory Surgery Center	X	X	X	X	X
Music City Surgery Center LLC	X	X	X	X	X
Nashville EndoSurgery Center	X	X	X	X	X
Nashville General Hospital	X	X	X	X	X
Nashville Midtown Surgical LLC	X	X	X	X	X
New Salem Surgery Center	X	X	X	X	X
NGS Endoscopy Center	X	X	X	X	X
Oral and Facial Surgery Center of Dickson	X	X	X	X	X
Patient Partners Surgery Center	X	X	X	X	X
Physicians Pavilion Surgery Center	X	X	X	X	X
Premier Orthopaedic Surgery Center	X	X	X	X	X
Premier Radiology Pain Management Center	X	X	X	X	X
Providence Surgery Center	X	X	X	X	X
Ramsey Way Surgery Center LLC	X	X	X	X	X
Riverview Regional Medical Center	X	X	X	X	X
Saint Thomas Campus SurgiCare LP	X	X	X	X	X
Southern Endoscopy Center	X	X	X	X	X
Southern Joint Surgery Center	X	X	X	X	X
Spine and Pain Physician Surgery Center	X	X	X	X	X
Spring Hill Surgery Center	X	X	X	X	X
Surgicenter of Murfreesboro	X	X	X	X	X
Tennessee Surgery Center	X	X	X	X	X
The Plastic Surgery Center Brentwood	X	X
The Surgery Center of Middle Tennessee	X	X	X	X	X
Tristar NorthCrest Medical Center	X		X	X	X
TriStar Southern Hills Medical Center	X		X	X	X
TriStar Stonecrest Medical Center	X		X	X	X
Trustpoint Hospital	X	X	X	X	X
Tullahoma Surgery Center	X	X	X	X	X
Turner Surgery Center LLC	X	X	X	X	X
Urology Surgery Center Inc	X	X
Vanderbilt Bedford Hospital	X	X	X	X	X
Vanderbilt Children’s Hospital	X	X	X	X	X
Vanderbilt Surgery Center Cool Springs	X	X	X	X	X
Vanderbilt Tullahoma Harton Hospital	X	X	X	X	X
Vanderbilt University Medical Center	X	X	X	X	X
Vanderbilt Wilson County Hospital	X	X	X	X	X
Wayne Medical Center	X	X	X	X	X
Wesley Ophthalmic Plastic Surgery	X	X	X	X	X
Westlawn Surgery Center	X	X	X	X	X

As part of the No Surprises Act, the Independent Dispute Resolution (IDR) process was set up to help insurers and providers reach agreement on specific claims to protect patients against unexpected medical bills from out-of-network providers.

Recently, many providers have been using the IDR process to receive much higher payments than what providers in our networks have agreed to. This could be why AMG refuses to return to our networks. This is unfortunate, as these costs are ultimately paid by Tennessee employers and members.

As a patient, your claims will not be directly affected. The purpose of the No Surprises Act is to protect patients against unexpected medical bills from out-of-network providers. However, misuse of the IDR process is leading to higher costs for everyone.

Self-funded employer groups are responsible for their own IDR payments, so Tennessee businesses are directly impacted by these higher costs.

Other employers, and BlueCross members, will be affected by IDR costs as they are factored into our premiums each year.

For providers

View the full list of providers' most frequently asked questions.

AMG providers offer care at the following facilities:

Baptist Ambulatory Surgery Center
Centennial Surgery Center
Clarksville Eye Surgery Center
Franklin Surgery Center
Northridge Surgery Center
Patient Partners Surgery Center
Southern Joint Surgery Center
St. Thomas Surgery Center of Clarksville
Summit Surgery Center
Summit Medical Center
Sumner Regional Medical Center
Surgery Center of Clarksville
Tennova Healthcare Clarksville
TriStar Centennial Medical Center - Nashville
TriStar Hendersonville Hospital
TriStar Horizon Medical Center
TriStar Skyline Medical Center
TriStar Summit Medical Center
Williamson Medical Center

Frequently Asked Questions

We’re committed to keeping you up to date on the latest information. Below are answers to your most commonly asked questions. Some of the terms we’ve used below may not be familiar. We’ve compiled a glossary of terms to help explain what each of the elements means.

The Situation

One of the most important things we can do for our members and customers is to help manage the rising costs of health care. Moving to the CareCentrix durable medical equipment network is one way we’re slowing cost increases while making sure members have access to care.

For our Commercial members, using an in-network CareCentrix medical equipment provider will result in significant cost-savings and keep their out-of-pocket costs as low as possible.

Yes, if you have Marketplace coverage or a BlueCare^SM, TennCareSelect, CoverKids or BlueCare Plus Tennessee plan, you must use an in-network provider. Your benefits don’t cover out-of-network providers or services. We’ll connect you with a new DME provider in the new network.
For Commercial, FEP and Medicare Advantage members, if your current provider doesn’t join the CareCentrix network, you can continue seeing them; but you’ll have to pay more for your care because your provider will no longer be in network. Getting your supplies from an in-network durable medical equipment provider is the most cost-effective way to get the services you need.

Your Care

Our members will still get the durable medical equipment supplies they need. In some cases, they may come from a different in-network provider, but this won’t affect the care they receive.

For prior authorization (PA) requests, we’ll continue reviewing internally from now until approximately June 1, 2026. CareCentrix (CCX) will review PA requests for all products and lines of business later this year.

Durable medical equipment is a product, not patient care. So, the cost of certain products is often negotiated and can be lower for the same type of DME. For example, a member can get the same nebulizer from one supplier or another. The item is the same, but the cost may be lower depending on where the member gets the product.

Members are getting the same equipment, but at a lower overall cost. This helps us provide members with more cost-effective ways to manage their medical care and lowers overall costs for our group customers.

Doctors and Health Facilities

Our members will still get the durable medical equipment supplies they need. In some cases, they may come from a different in-network provider, but this won’t affect the care they receive.

For prior authorization (PA) requests, we’ll continue reviewing internally from now until approximately June 1, 2026. CareCentrix (CCX) will review PA requests for all products and lines of business later this year.

Durable medical equipment is a product, not patient care. So, the cost of certain products is often negotiated and can be lower for the same type of DME. For example, a member can get the same nebulizer from one supplier or another. The item is the same, but the cost may be lower depending on where the member gets the product.

Members are getting the same equipment, but at a lower overall cost. This helps us provide members with more cost-effective ways to manage their medical care and lowers overall costs for our group customers.

Scheduled Procedures/Ongoing Treatment

Our members will still get the durable medical equipment supplies they need. In some cases, they may come from a different in-network provider, but this won’t affect the care they receive.

For prior authorization (PA) requests, we’ll continue reviewing internally from now until approximately June 1, 2026. CareCentrix (CCX) will review PA requests for all products and lines of business later this year.

Durable medical equipment is a product, not patient care. So, the cost of certain products is often negotiated and can be lower for the same type of DME. For example, a member can get the same nebulizer from one supplier or another. The item is the same, but the cost may be lower depending on where the member gets the product.

Members are getting the same equipment, but at a lower overall cost. This helps us provide members with more cost-effective ways to manage their medical care and lowers overall costs for our group customers.

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