Insurance

Health Insurance and Billing

Insurance and Billing Information

East Tennessee Children's Hospital accepts all health care plans, and many companies have contractual agreements with us. Patient families should check with their health insurance provider to see if the provider has a contract with us. If no contract exists, the insurance company may require the patient have an out-of-network referral. We will accept the insurance regardless of the referral; however, the insurance company may not cover as much of the cost of the visit as it would for an in-network hospital. The balance of any bill after insurance payments are made is the responsibility of the patient's parent or guardian.

For questions about insurance, call the East Tennessee Children's Hospital Billing and Collection Department (Patient Accounts) at (865) 541-8187.

For questions regarding balances after insurance and payment arrangements, please contact Children's Hospital Self Pay at (865) 544-4343.


Insurance Providers for Children's Hospital

Children's Hospital has agreements with the following health insurance networks:

TennCare Networks

  • Amerigroup Community Care
  • United Health Care Community Plan (UHCP, formerly known as AmeriChoice): United Health Care Community Plan
  • Blue Care (BlueCross): BlueCare
  • TennCare Select (Blue Cross): TennCare Select, TennCare Select BPN Network
  • CoverKids of Tennessee (BlueCross)

Government Network

  • Tricare: Prime and Select

Commercial Health Plans Participation

  • Aetna Health Plans: HMO, Open Access HMO, Aetna Select, Aetna Open Access Select, EPO, Open Access EPO, QPOS-Aetna Quality Point of Service, Aetna Choice POS and POSII, Managed Choice, Health Network Option, Open Choice-PPO, Open Access Managed Choice
  • Amera-Net: PPO+
  • BeechStreet: PPO, Concentra
  • Blue Cross Blue Shield of Tennessee
  • Blue Cross Network P (Preferred): BluePreferred PPO, BlueCard Program
  • Blue Cross Network S (Select): BlueSelect PPO, POS, BlueCard Program
  • Blue Cross Network K: Network K, PPO, POS (limited availability)
  • BlueGrass Family Health Plans: PPO
  • CIGNA / Great West Health: Open Access Plus-PPO, HMO and Open Access HMO, PPO, EPO, Cigna POS, Indemnity
  • Community Health Alliance (CHA)
  • Coventry Healthcare / First Health: PPO
  • Evolutions Healthcare Systems: Select, Select Plus
  • First Health / Coventry Healthcare: First Health PPO
  • Galaxy Health Network: PPO
  • Great West Health / CIGNA: Open Access Plan, POS, PPO
  • Health Payor's Organization, Ltd: PPO
  • Humana ChoiceCare: PPO, HMO, POS-Open Access, PPO, Humana Classic, HumanaOne, CHA, PPOx, HMOx, Choice POS
  • Interplan Health Group: PPO
  • Multiplan / PHCS: PPO
  • National Preferred Provider Network (NPPN): PPO
  • PPO Next: National Access, National Access Plus
  • PRIME Health Services: PPO
  • Private Healthcare Systems (PHCS) / Multiplan: PPO / TPA's
  • Provider Select, Inc: PSI-PPO
  • The Initial Group: PPO / TPA's
  • Three Rivers Provider Network: PPO
  • United HealthCare / United HealthCare of the River Valley: United Choice, United Choice Plus, United of the River Valley, Options PPO
  • USA Managed Care Organization: PPO

Financial Assistance Program

East Tennessee Children's Hospital recognizes that medical problems can sometimes create financial problems. Our staff is here to assist you in finding resources that may help cover your medical expenses. There are options for every family. In order to qualify for other hospital assistance programs all possible insurance options must be exhausted by the family.

All patient charges are the same regardless of insurance coverage. Discounts will vary based on specific contracts with individual insurance companies.

All families are expected to set up payment arrangements to begin the first month they are billed. If that is a hardship, please apply for financial assistance (see below).


Children's Hospital will help provide financial assistance to all families. Financial Assistance is available as to any hospital charges, including emergency charges. We offer assistance in the following ways:

  • Help you determine what programs are available and if you would qualify for assistance
  • Help direct you to possible insurance coverage and assist you in how to apply
  • Determine any applicable discount amounts for uninsured patients
  • Families with no insurance are given a 40% discount from charges and an additional 20% discount if they pay the balance in full within the first 30 days after they receive the bill.
  • Provide Financial Assistance Form to review for charity care

Please contact a Patient Account Representative at 865-541-8187 Monday through Friday between 8 a.m. - 4:30 p.m. for help.


Charity Care

We offer charity care for any family who earns less that 200% of the current Federal Poverty guidelines. For example: In 2015, a family of four could earn up to $47,700.00 to qualify. These amounts are updated annually. • There are no automatic charity adjustments given. Families must apply for all possible insurance coverage before we will consider you for charity care. Once you have exhausted all insurance options we will assist you with an application for charity care.


To apply for charity care:

  • Call a Patient Account Representative at 865-541-8187 Monday through Friday between 8-4:30 for help.
  • Print a copy of the Financial Assistance Form

Please mail your completed application to:

East Tennessee Children's Hospital
P.O. Box 15010
Knoxville, TN 37901-5010
Attn: Business Office Director


Applications will be processed within 2 weeks of receipt. A letter will be mailed to confirm approval or denial. If approved it is for the hospital bills only. The letter you receive can be used to show assistance at Children's Hospital. This will many times qualify your family for assistance with other providers who cared for your child. Those offices must be contacted separately to verify if they will offer assistance. Some of the most frequent providers are:

  • Team Health: 888-952-6772
  • Vista Radiology: 865-766-0112
  • Anesthesia: 877-288-1799

Self Pay

If your family is denied or does not request financial assistance, our self pay department will assist in setting up a monthly plan that works for your family's budget.

  • Once all insurance has paid, your account balance will move to our self pay department. That account will remain in that department as long as needed
  • Payments must be made monthly. If a problem arises with keeping that payment plan you must contact us. When families keep us informed, we will work with them.
  • Accounts are kept in our self pay department for 240 days before going to collections.
  • Accounts are only placed in collections for the following reasons: refusal to pay and mail return with no additional contact information.
  • Nonpayment of an account can result in legal proceedings and have a negative impact on your credit rating.
  • Accounts are not reported to the credit bureau until the point we get to legal proceedings.
  • Financial Assistance Applications are accepted at any point in the process. There is no time limit to apply for assistance.

If you are in need of Self Pay Assistance, please call the Self Pay Patient Account Representatives at 865-544-4343 or 1-888-296-8111 Monday through Friday between 8:30 a.m. to 4 p.m.


Our staff's goal is to exceed your expectations and help you in understanding your financial responsibility. Please do not hesitate to contact us in Patient Accounts with any questions or concerns. Again our number is (865) 541-8187. Thank you for choosing East Tennessee Children's Hospital for your child's health care needs. It is always our pleasure to serve you.

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