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East Tennessee Children's Hospital >> Patients & Families >> Health Insurance Information

Health 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.

For questions about billing, insurance and self pay, call the East TN Children's Hospital Billing and Collection Department at (865) 541-8187.

Insurance Providers for Children's Hospital

The balance of any bill after insurance payments are made is the responsibility of the patient's parent or guardian. 

Children's Hospital has agreements with the following 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)

Children's Hospital has an agreement with the following Government network:

  • Tricare -- Prime and Select

 Children's Hospital participates in the following commercial health insurance plans:  

  • 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


CoverKids TN

CoverKids is a federally and state funded health plan through the State Children's Health Insurance Program, which provides comprehensive health and dental coverage to children in families who do not qualify for Medicaid, but cannot afford private health insurance.

Families may apply online at www.CoverKids.com or by calling (866) 620-8864.

CoverKids is a program of Cover Tennessee, Governor Bill Haslam's initiative to address the health care needs of Tennessee's uninsured. CoverTennessee offers three other programs, including CoverTN, a limited benefit health plan for the working uninsured. AccessTN offers comprehensive health insurance for those who are uninsurable due to pre-existing medical conditions and CoverRx provides access to affordable prescriptions for Tennesseans who lack pharmacy benefits. For more information about any of the Cover Tennessee programs, visit www.CoverTN.gov or call 1-866-COVERTN (1-866-268-3786).

Financial Assistance Program

East Tennessee Children's Hospital recognizes that unexpected medical problems can create unexpected financial problems. Our staff is here to assist you in finding resources that may help cover your medical expenses. Every patient we treat with no insurance coverage is automatically eligible for discounts.

We will help provide financial assistance to all families. We are able to offer assistance in the following ways:

  • Help you determine what programs you may qualify for
  • Help direct you to possible insurance coverage and assist you in how to apply
  • Determine any applicable discount amounts for uninsured patients
  • Fill out a Financial Assistance Form for review for charity care.

Based upon your family's earnings, you may also qualify for discounts, payment terms or charity care. If you need financial assistance, please call our Patient Account Representatives at (865) 541-8187, Monday through Friday between 8:30 a.m. and 4 p.m.

Charity Policy

For families who do not qualify for other assistance programs, we provide discounts based on the family's income:

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.

Our staff goal is to exceed your expectations 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