Frequently Asked Questions
The Situation
As of July 1, 2024, CHI Memorial facilities are no longer included in Blue Network S. Members of this plan may seek in-network care at Erlanger, Parkridge Health System or our other in-network physician groups. BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our members, so we are encouraging them to check with their CHI Memorial providers before receiving care.
After reaching an agreement in 2021 that provided CHI Memorial higher rates, they insisted on a “hard termination” of that contract, set for June 30, 2024. In 2023, CHI Memorial asked to end our contract early and demanded significant rate increases. Instead, we opted to keep our contract’s original timeline and negotiate a new contract in 2024 as part of our ongoing efforts to help control the cost of care.
We’ve reached an agreement to keep CHI Memorial facilities and providers in our Blue Network PSM, Medicare Advantage and BlueCare networks. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
CHI Memorial Health at Home has also rejoined these networks.
We’ve reached a deal to keep Memorial in our Network P, Medicare Advantage and BlueCare plans. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
As of July 1, CHI Memorial facilities are no longer in Blue Network S and Parkridge Health System has officially joined Erlanger in Network S in Chattanooga.
Network S members can visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services, facilities and providers they offer.
For more on how we reached this decision, click here.
After reaching an agreement in 2021 that provided CHI Memorial higher rates, they insisted on a “hard termination” of that contract, set for June 30, 2024. In 2023, CHI Memorial asked to end our contract early and demanded significant rate increases. Instead, we opted to keep our contract’s original timeline and negotiate a new contract in 2024 as part of our ongoing efforts to help control the cost of care.
We’ve reached an agreement with CHI Memorial regarding Blue Network PSM, Medicare Advantage and BlueCare. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
As of July 1, CHI Memorial facilities are no longer in Blue Network S. Parkridge Health System has officially joined Erlanger in Network S in Chattanooga. Members may continue to seek care with Parkridge, Erlanger or our physician groups for in-network rates.
BlueCross will continue to cover Network S member visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care.
CHI Memorial’s pattern of behavior and unreasonable rate requests led us to reevaluate our partnership. We asked CHI Memorial and HCA Parkridge to compete for a spot in Blue Network S alongside Erlanger to maintain affordability for our members.
Parkridge Health System showed a greater ability to serve our Network S members at a fair rate and provides almost every service CHI Memorial offers, including oncology and cardiology, as well as psychiatric care, obstetrics and maternity care, and freestanding emergency services.
We’ve reached agreement with CHI Memorial for Blue Network P, Medicare Advantage and BlueCare plans, so members with this coverage can use Memorial facilities and providers at in-network rates.
As of July 1, CHI Memorial and affiliated providers and facilities are out-of-network for members with a Network S planwill have in-network access to CHI Memorial through June 30. BCBST provided CHI Memorial multiple proposals with rate increases to keep the system’s physicians in Network S. CommonSpirit rejected these offers, choosing to keep their CHI Memorial Medical Group and Chattanooga Heart Institute providers from serving Network S members.
As of July 1, Parkridge Health System is our new Network S partner alongside Erlanger. Network S members can visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services, facilities and providers they offer.
As of July 1, CHI Memorial and affiliated providers and facilities are out-of-network for our Blue Network S plan. BCBST provided CHI Memorial multiple proposals with rate increases to keep the system’s physicians in Network S. CommonSpirit rejected these offers, choosing to keep their CHI Memorial Medical Group and Chattanooga Heart Institute providers from serving Network S members. However, Network S members can find an excellent range of care for in-network rates at Erlanger, Parkridge Health System or our participating in-network physician groups.
BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care.
Members of our Network P, Medicare Advantage and BlueCare plans may continue to seek care with CHI Memorial and affiliated providers at in-network rates through June 30 and beyond.
Your Care
If you’re a Network S member, you may have received an email or other communication from Memorial on or around June 19 stating that CHI Memorial will “support Network S PPO plan patients from July 1 through December 31, 2024, by continuing to accept Network S patients at our hospitals and physician clinics in accordance with BCBST’s prior authorization policies.”
As we said earlier this year, we’re applying in-network benefits for Network S claims by Memorial doctors. That doesn’t apply to hospital-based services like imaging or surgical procedures. Our care teams, guided by our senior clinical leaders, are already working directly with members to reschedule facility services with in-network providers.
We’re confident that the in-network providers available to our Network S members will provide high-quality care at the most affordable prices. We encourage you to explore these options, including Erlanger, Parkridge and many independent physician practices.
If you plan to use Memorial with a Network S plan, please contact Memorial prior to receiving care to understand your financial responsibility. And remember, you can make the most of your benefits by using an in-network provider.
If you or a family member is a member of our Blue Network S plan, then any care you receive from CHI Memorial facilities or providers is considered out-of-network as of July 1, 2024.
If you or a family member is a member of Network P, Medicare Advantage or BlueCare, your plan will remain in network beyond June 30, which means you do not have any change to your plan or your in-network options.
Members of Network S with services scheduled at a CHI Memorial facility can get support from our care teams so they can continue to receive appropriate care from an in-network provider. View our list of alternative in-network facilities where you can seek care.
BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care. BlueCross will not continue paying in-network rates for CHI Memorial facilities or ancillary services, like care received at a hospital, surgery center or imaging center. So, Network S members should seek an in-network option for non-emergent hospital, laboratory or imaging needs.
Under our Continuity of Care policy, some CHI Memorial 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 you qualify for in-network status, please call our Member Service line at 1-800-565-9140 or complete this form and return it to: BlueCross BlueShield of Tennessee, 1 Cameron Hill Circle, Ste. 0002, Chattanooga, TN 37402-0002.
BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHII Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care. BlueCross will not continue paying in-network rates for CHI Memorial facilities or ancillary services, like care received at a hospital, surgery center or imaging center. So, Network S members should seek an in-network option for non-emergent hospital, laboratory or imaging needs.
In the meantime, we are here to help with the transition, including helping you find care with in-network providers or facilities. Visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services, facilities and providers they offer.
Most members will need to stay in the plans or networks they’ve enrolled in for 2024. We always want you to be happy with your options for care, and we understand that network changes can be frustrating. We’ll be standing by to support you, and our care teams will help make sure you keep getting the services you need.
Effective July 1, CHI Memorial affiliated providers and facilities are out-of-network for members with a Network S plan. We will do everything in our power to help you find alternative providers, facilities or care. Visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services they offer.
Our 2024 Medicare Advantage plans include generous out-of-network benefits to help keep your costs low. This means that, as long as CHI Memorial agrees to see you, you could continue seeing your preferred CHI Memorial-affiliated providers with limited cost differences.
To see the out-of-network benefits included in your plan, look at your Evidence of Coverage (EOC) here. You can find your BlueAdvantage plan on the middle left side of your Member ID card so you know which EOC to review.
If you are a member of our Network P, BlueCare or Medicare Advantage networks, you may continue to seek care with CHI Memorial-affiliated providers or facilities at in-network costs.
If you are a Network S member, all CHI Memorial-affiliated providers and facilities are out-of-network, effective July 1. 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 facilities where you and your family can get care. You can call the Member Service telephone number on the back of your Member ID card or visit bcbst.com to find in-network providers. You can also visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services they offer.
Yes, you should always go to the closest emergency room in a true emergency. Emergency room benefits for true emergencies will not be affected even though CHI Memorial left our Network S plan on July 1. Please note that, if admitted and once stabilized, you will need to be transferred to an 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 are in Network S, CHI Memorial-affiliated providers or facilities are considered out-of-network, effective July 1.
BlueCross Network S members can call the telephone number on the back of their Member ID card to receive one-on-one support with transitioning their care from CHI Memorial to a new provider. Our “Find Care” tool can also assist with identifying new providers in-network. Network S members can also visit our Parkridge page, Erlanger page or in-network physician groups page to learn more about the services they offer.
We are happy to announce we’ve reached a deal with Memorial regarding Network P, Medicare Advantage and BlueCare. Members of these plans may continue to see their CHI Memorial providers through June 30 and beyond.
We are happy to announce that we’ve reached a deal with Memorial regarding Network P, Medicare Advantage and BlueCare that allows members of these plans to receive care at in-network rates beyond June 30. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs.
BCBST provided CHI Memorial multiple proposals with rate increases to keep the system’s physicians in Network S. CommonSpirit rejected these offers, choosing to keep their CHI Memorial Medical Group and Chattanooga Heart Institute providers from serving Network S members. As a result, any care that Network S members receive from a CHI Memorial-affiliated provider or facility is considered out-of-network as of July 1, and you may be charged more.
BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHII Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care. BlueCross will not continue paying in-network rates for CHI Memorial facilities or ancillary services, like care received at a hospital, surgery center, or imaging center. So, Network S members should seek an in-network option for non-emergent hospital, laboratory or imaging needs.
For Network S, CHI Memorial facilities and affiliated providers are no longer in-network as of July 1, 2024. BlueCross will not continue paying in-network rates for CHI Memorial facilities or ancillary services, like care received at a hospital, surgery center or imaging center. So, Network S members should seek an in-network option for non-emergent hospital, laboratory or imaging needs. Before getting care, we recommend Network S members check our provider directory to see if their caregiver is in-network.
Network P, BlueCare and Medicare Advantage members may continue seeking care at CHI Memorial-affiliated facilities at in-network costs. This includes CHI Memorial Health at Home.
Yes, CHI Memorial-affiliated physician groups and providers are included in this change. This means, if you are a Network S member and continue to see a CHI-affiliated provider or physician group, your care is considered out-of-network effective July 1. BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care.
Members of our Network P, Medicare Advantage and BlueCare plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs.
Scheduled Procedures/Ongoing Treatment
We are happy to announce we’ve reached a deal with Memorial regarding Network P, Medicare Advantage and BlueCare that allows these plans to stay in-network. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
As of July 1, CHI Memorial facilities are no longer in-network with Blue Network S.
That means, if you are a Network S member, you will pay more for the same care that you could receive from an in-network facility, and in some cases, you will have to pay the full amount for that care. Our goal is to be sure you have few disruptions in care. If you have a service scheduled at a CHI Memorial facility, a nurse from BlueCross will work with you to help make sure you receive appropriate care. If you are a Network S member and your procedure was scheduled on or after July 1, call us at the telephone number on your Member ID card for help getting those services moved to an in-network provider.
A note about home care: If you have surgery and need home care, call the telephone number on the back of your Member ID card to ensure your home-care option is in-network, as CHI Memorial Health at Home has left our Network S plan.
Please see our continuity of care policy if you are currently undergoing treatment for cancer. We are happy to announce we’ve reached a deal with Memorial regarding Network P, Medicare Advantage and BlueCare that allows these plans to stay in-network. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
As of July 1, CHI Memorial facilities are no longer in-network with Blue Network S.
That means, if you are a Network S member, you will pay more for the same care that you could receive from an in-network facility, and in some cases, you will have to pay the full amount for that care. Our goal is to be sure you have few disruptions in care. If you have a service scheduled at a CHI Memorial facility, a nurse from BlueCross will work with you to help make sure you receive appropriate care. If you are a Network S member and your procedure was scheduled on or after July 1, call us at the telephone number on your Member ID card for help getting those services moved to an in-network provider.
BlueCross will continue to cover visits with CHI Memorial providers at our current in-network rates. However, we cannot prevent CHI Memorial from balance billing our Network S members, so we are encouraging them to check with their CHI Memorial providers before receiving care. BlueCross will not continue paying in-network rates for care from CHI Memorial facilities or ancillary services, like care received at a hospital, surgery center or imaging center. So, Network S members should seek an in-network option for non-emergent hospital, laboratory or imaging needs.
We are happy to announce we’ve reached a deal with Memorial regarding Network P, Medicare Advantage and BlueCare that allows these plans to stay in-network. Members of these plans may continue to seek care with CHI Memorial and affiliated providers at in-network costs, through June 30 and beyond.
As of July 1, CHI Memorial facilities are no longer in-network with Blue Network S.
That means, if you are a Network S member, you will pay more for the same care that you could receive from an in-network facility, and in some cases, you will have to pay the full amount for that care. Our goal is to be sure you have few disruptions in care. If you have a service scheduled at a CHI Memorial facility, a nurse from BlueCross will work with you to help make sure you receive appropriate care. If you are a Network S member and your procedure was scheduled on or after July 1, call us at the telephone number on your Member ID card for help getting those services moved to an in-network provider.
A note about home care: If you have surgery and need home care, call the telephone number on the back of your Member ID card to ensure your home-care option is in-network, as CHI Memorial Health at Home has left our Network S plan.