East Tennessee Children’s Hospital

We’re working to reach a new agreement with East Tennessee Children’s Hospital (ETCH) to keep them in our BlueCare networks. We’ll keep you up to date on our negotiations and what you need to know about seeking care.

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ETCH Frequently Asked Questions

Last Updated on October 6, 2025

We’re committed to keeping you up to date on the latest information. Below are answers to your most commonly asked questions. We’ll update this page frequently, so please check back for more information. 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

We hope not. We are currently negotiating with East Tennessee Children’s Hospital (ETCH) in order to reach an agreement on a new contract for our BlueCare and TennCareSelect networks. We value the care that ETCH clinicians provide and are committed to working toward a resolution that supports affordability and access for the Tennessee communities we serve.

Our current BlueCare and TennCareSelect contracts with ETCH extend through October 31, 2025. If we aren’t able to come to an agreement before October 31, ETCH providers and facilities will be considered out of network for our BlueCare and TennCareSelect members beginning November 1, 2025.

All other BlueCross plans will be unaffected and remain in-network with ETCH, through October 31 and beyond.

If a new agreement is not reached, all ETCH facilities and providers will be removed from BlueCare and TennCareSelect plans. All other BlueCross plans will be unaffected and remain in-network with ETCH, through October 31 and beyond. If a new agreement is not reached, all ETCH facilities and providers will be removed from BlueCare and TennCareSelect plans. All other BlueCross plans will be unaffected and remain in-network with ETCH, through October 31 and beyond.

The role of BlueCross BlueShield of Tennessee is to provide access to quality care at the best possible prices. Our members are asking us for help in managing rapidly rising healthcare costs, and we’re responding by making changes that will provide them with much-needed savings. These changes include improving the way we review claims before they’re paid, to make sure they accurately align with the services provided, adjusting payment policies for mid-level providers, and lowering lab and drug costs in the BlueCare Tennessee program.

We’re working to negotiate an agreement that will keep its clinicians and facilities in our BlueCare and TennCareSelect networks. We want to assure all our members that they will continue to have in-network access at ETCH facilities and with their physicians through October 31, 2025 – and beyond, if they agree to reasonable rates. We’re sharing this information now because we believe you deserve transparency.

If we cannot reach an agreement, ETCH will leave our BlueCare and TennCareSelect plans after October 31, 2025. If you are covered by one of our impacted plans, any care you receive at ETCH facilities or from its affiliated providers on or after November 1, 2025, will be considered out of network.

All other BlueCross plans will be unaffected and remain in-network with ETCH, through October 31 and beyond.

Your Care

If an agreement is not reached by October 31, 2025, all BlueCare and TennCareSelect members will need to seek care from other facilities beginning November 1, 2025.

If you’re covered by one of our BlueCare and TennCareSelect plans, any care you receive at ETCH facilities or from affiliated providers on or after November 1, 2025, will be considered out of network, and you will likely be required to pay more for the care you receive there.

Our 2025 BlueCare and TennCareSelect plans include several generous out-of-network benefits to help mitigate costs. This means that you could continue using your preferred ETCH-affiliated providers with nominal cost differences, even if we are unable to reach an agreement and they go out of network on November 1, 2025.

To see the out-of-network benefits included in your plan, consult your Evidence of Coverage here. These are based on your BlueCare plan, which you can find on the bottom left corner of your Member ID card.

We’re committed to coordinating care for our members and helping them get the services they need. We maintain an excellent network of hospitals and surgery centers where you and your family can receive care. Your BlueCare and TennCareSelect plans give you the freedom to visit the in-network healthcare facility of your choice. Members can call the telephone number on the back of their Member ID card or visit bcbst.com for help finding alternative care options.

However, if we’re unable to reach an agreement, you’re a BlueCare o TennCareSelect member, and you use an ETCH facility or clinician on or after November 1, 2025, you’ll be getting care from an out-of-network facility. This means you’ll pay more for the same care that you could receive from an in-network facility, and in some instances be responsible for the full cost of that care. View our list of alternative in-network facilities where you can seek care if ETCH does go out of network.

Yes, your BlueCare and TennCareSelect plans give you the freedom to visit the in-network healthcare facility of your choice. Our current contract with ETCH extends through October 31, 2025, so you can and should continue to use their facilities or affiliated providers until that time. However, if we are unable to reach an agreement and you use an ETCH facility or physician on or after November 1, 2025, you will be seeing a provider that’s out of network. That means you will pay more for the same care that you could receive from an in-network hospital or provider, and in some cases will have to pay the entire amount for that care.

Yes, you should always go to the closest emergency room. Emergency room benefits for true emergencies will not be affected if ETCH leaves our BlueCare and TennCareSelect networks. Covered emergency room benefits for true emergencies are covered as in-network. Please note that, if admitted and once stabilized, you will need to be transferred to a participating in-network facility. See below for the definition of a true emergency.

An emergency is defined as a sudden and unexpected medical condition that manifests itself by symptoms of sufficient severity, including severe pain, that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect to result in:

serious impairment of bodily functions

serious dysfunction of any bodily organ or part

placing a person’s health in serious jeopardy

Examples of emergency conditions include: (1) severe chest pain, (2) uncontrollable bleeding and (3) unconsciousness.

Doctors and Health Facilities

If you have a BlueCare Tennessee or TennCareSelect health plan, then any care you receive from ETCH-affiliated providers will be considered out of network after October 31, 2025. This means you will likely be required to pay more for the care you receive on or after November 1, 2025.

We’re working hard to reach agreement because we know that ETCH facilities and providers are the top choice for many BlueCare and TennCareSelect members in the Knoxville area. We urge you to use our provider directory to see if your caregiver is in network.

All other BlueCross plans will be unaffected and remain in-network with ETCH, through October 31 and beyond.

Yes, it includes all facilities owned/operated by West Tennessee Healthcare. If we are not able to come to an agreement before Feb. 12, 2021, the West Tennessee Healthcare clinics listed below will be considered out-of-network.

[Cardiology Outreach Clinic, Camden]
[Cardiology Outreach Clinic, Lexington]
[Cardiology Outreach Clinic, Paris]
[Dizziness and Balance Clinic, Jackson]
[Heart Rhythm Clinic, Jackson]
[Lexington Medical Clinic]
[Lift Health Clinic, Jackson]

Yes, this will impact imaging centers that are owned/operated by West Tennessee Healthcare, and its facilities that offer imaging services. Again, this change will not take place until Feb. 13, 2021. We hope to reach an agreement to keep these facilities in-network.

If you have an authorized test scheduled at a WTH facility or with a WTH-affiliated provider between now and Feb. 12, 2021, you will be considered in-network. Any authorized tests as of Feb. 13, 2021, will be considered out-of-network and you will likely be required to pay more for the care you receive. In addition to the hospital, the facilities offering imaging services listed below are part of West Tennessee Healthcare.

[West Tennessee Imaging Center, Jackson]
[West Tennessee Neuroscience & Spine, Jackson]
Prime Care Medical Center, Selmer

Yes, this will impact rehabilitation and physical therapy services that are owned/operated by West Tennessee Healthcare. Again, this change will not take place until Feb. 13, 2021. We hope to reach an agreement to keep these facilities in-network.

If you have an appointment scheduled at a WTH facility or with a WTH-affiliated provider between now and Feb. 12, 2021 you will be considered in-network. Any appointments on or after Feb. 13, 2021, will be considered out-of-network and you will likely be required to pay more for the care you receive. The facilities listed below are part of West Tennessee Healthcare.

Lift Center, Jackson
[Sports Plus AquaTherapy, Jackson]
[Sports Plus RehabCenters
- Alamo
- Brownsville
- Dyersburg
- Henderson
- Humboldt
- Lexington
- Medina
- Milan
- North, Jackson
- South, Jackson
- Trenton]
[Work Plus Rehab Center, Jackson]

Yes, this will impact behavioral health services that are owned/operated by West Tennessee Healthcare. Again, this change will not take place until Feb. 13, 2021. We hope to reach an agreement to keep these facilities in-network.

If you have an appointment scheduled at one of the Pathways Behavioral Health facilities between now and Feb. 12, 2021, you will be considered in-network. Any appointments as of Feb. 13, 2021, will be considered out-of-network and you will likely be required to pay more for the care you receive.

The behavioral health facilities listed below are part of West Tennessee Healthcare.

[Pathways, Dyer County
Pathways, Haywood County
Pathways, Henderson County
Pathways, Jackson
Pathways, Obion County
Pathways Employee Assistance Program, Jackson
Pathways, Lake County
Pathways Peer Support Center – Comfort Center, Lexington
Pathways Peer Support Center – Hope House, Dyersburg
Pathways Peer Support Center – Rainbow Center, Jackson]

If your baby arrives between now and October 31, 2025, and is transferred to ETCH, they’ll still be in network, meaning you’ll still have your standard benefits there. If your baby arrives on or after November 1, 2025 and is transferred to ETCH, they’ll be considered out of network, so you’ll have to pay more for that care.

Your BlueCare and TennCareSelect plans give you the freedom to visit the hospital of your choice. However, if we’re unable to reach an agreement and you use an ETCH facility on or after November 1, 2025, you’ll be getting care out of network. That means you’ll pay more for the same care that you could receive from an in-network facility, and in some cases will have to pay the full amount for that care.

Scheduled Procedures/Ongoing Treatment

In the event we don’t reach an agreement by October 31, 2025, you’ll have a few options when it comes to your care.

If your child has ongoing services scheduled at ETCH or an affiliated outpatient facility, a nurse from BlueCross will work with you to help make sure they continue to receive appropriate care from an in-network healthcare provider. We want to be sure there are no disruptions in care.

Under our Continuity of Care policy, some ETCH patients may be granted in-network status. Patients who may qualify for this status include:

Patients whose practitioner/facility are terminated from the network during treatment, i.e., chemotherapy or radiation patients

Patients with complex medical and/or behavioral health conditions

If you think your child qualifies for in-network status, please call the Member Service telephone number on the back of your Member ID card or complete this form and return it to: BlueCross BlueShield of Tennessee, 1 Cameron Hill Circle, Ste. 0002, Chattanooga, TN 37402-0002.