BlueCross BlueShield of Tennessee offers two Medicare Advantage Local Preferred Provider Organization (LPPO) products: BlueAdvantage Sapphire and BlueAdvantage Diamond. Currently the county Service Area for the  LPPO is Knox, Loudon, Sevier, and Anderson counties.  Effective January 1, 2009, we will add Sullivan, Hawkins, Hancock, Greene, Hamblen, Jefferson, Campbell, Roane, Warren, Marion, Hamilton, Bradley, Polk, Davidson, Carroll, Weakley, Dyer, and Shelby.

A Local Preferred Provider Organization plan is a Medicare Advantage (MA) plan that has a network of contracted providers that have agreed to treat plan members for a specified payment amount.  A PPO plan must cover all plan benefits whether they are received from network or non-network providers.  Member cost-sharing may be higher when plan benefits are received from non-network providers.

Sample ID Card

BlueAdvantage PPO Health Management

UM Review Requirements

Learn more about BlueCross BlueShield of Tennessee Medicare Advantage plans:

• Cardiac Inpatient Prior Authorization Fax Form 
• DME Prior Authorization Fax Form
• General Prior Authorization Fax Form
• HIT Prior Authorization Fax Form
• Inpatient Prior Authorization Fax Form
• Oncology Drug Prior Authorization Fax Form
• Outpatient Therapy Prior Authorization Fax Form
• Part B Drug Prior Authorization Fax Form
• SNF Inpatient Rehab Prior Authorization Fax Form
• Physician Health Risk Assessment Tool