Our goal is to provide quality health information on the BlueCross BlueShield of Tennessee Web site while respecting your rights for privacy and informed use of the site. With this in mind, we would like to explain how this site works and how we obtain its content. While we are committed to quality content, we do not intend for information on the site to act as a substitute for health care or medical advice from a professional. All questions about individual care or treatment should be referred to your health care provider.
BlueCross BlueShield of Tennessee has a formal Code of Conduct policy that includes a conflict of interest section, and establishes guidelines, principles, and ethics by which all staff members, including those contributing to the site, must abide. Staff members are also required to review and to complete a training course on these policies annually. Contractors must sign a confidentiality agreement and, just like employees, must annually complete the Corporate Code of Conduct training program. Contractors and third parties are subject to BCBST standards for design, security, quality and compliance with government and industry requirements. For more details, see the online version of our Code of Conduct.
BlueCross BlueShield of Tennessee is dedicated to bringing you unbiased, quality content on this site. Business relationships with a third party that could jeopardize the objectiveness of data or content will be stated on the site. Internal staff must avoid financial or other interests in any entity perceived to have an influence on the integrity of site content. Content is reviewed and approved at several levels in the publishing process.
At least once a year the BCBST Compliance Department distributes a conflict of interest questionnaire to all employees based upon their particular job duties. Persons who receive the questionnaire must answer all questions fully and accurately, must certify as to the accuracy of the information given, and update that information whenever necessary.
Any potential conflicts of interest must be disclosed to the employee's supervisor at the time of hire or at the time that the financial or other interest develops. The supervisor will determine whether a conflict exists and, if so, what actions should be taken to eliminate or avoid the conflict.
BlueCross BlueShield of Tennessee is a not-for-profit independent licensee of the BlueCross BlueShield Association. BCBST maintains editorial independence and requires a separation between editorial and commercial interests.
The services above are secure services that will require you to submit personally identifiable information. For the sales application, you may be required to submit personal health information for underwriting purposes.
BlueCross BlueShield of Tennessee has formed strategic partnerships to deliver to visitors of our site a wide variety of high quality heath content and services. Partners are subject to BCBST’s standards for design, security, quality and compliance with government and industry requirements, which were agreed to at the time of contract. BlueCross BlueShield of Tennessee does not monitor or review the health content on these sites. Each site has its own editorial staff and editorial review process. You should read the editorial review policies of these sites to understand how these sites handle their content review.
Shared Health, Inc. a wholly-owned subsidiary of BlueCross BlueShield of Tennessee - offers secure, innovative health information technology (Health IT) solutions. Today, Shared Health is the largest public/private data sharing initiative of its kind in the United States. In addition to providing Health IT solutions to government payers, Shared Health is also branching into commercial payer markets. Shared Health’s core solutions - the Shared Health ePrescribe and the Shared Health (CHR) Consumer View - provide greater accuracy, increased safety and efficiency, and ultimately, more effective patient treatment and outcomes. Additionally, the CHR - Consumer View offers consumers access to the CHR, supporting the trend of increasing consumer responsibility and empowering consumers to access their own information about their own health care. Shared Health, Inc. agrees to notify you of what personally identifiable information is collected from you through the Web site, the organization collecting the information, how the information is used and with whom it is shared. They will also inform you of your choices regarding collection, use and distribution of the information; security procedures in place to protect the loss, misuse or alteration of your information; and how you can correct any inaccuracies in the information. For more information, see their Privacy Statement and Site Usage.
It is the policy of BlueCross BlueShield of Tennessee to present information to all users of the site in language that is clear, easily read and easily understood and to comply with all state and federal regulations which may apply to those communications.
Content Selection Criteria
Content on this site is submitted to a rigorous, multi-layered approval process. The material is reviewed to ensure that it meets the following criteria:
Original health content must meet the following additional criteria:
1) Evidence-Based Medicine - Topics based on the use of current best available external clinical evidence in making decisions about patient care.
2) Clinical Significance - Medical findings published in peer-reviewed medical journals.
3) Relevance - News and topics that may affect your health and your health care choices.
4) Trends - Health issues currently in the news or a matter of public health awareness; community practice standards.
Health Content Approval and Sources
To ensure the highest quality of health content possible, all health content goes through a special approval process before it is published on the site. Dr. Rich Cassidy, Chief Medical Officer, has clinical oversight responsibility for the health content approval process.
- Jaberta Evans - Corporate Communications
- Inga Himelright, MD - Associate Chief Medical Officer
- Deborah Webb, MD Medical Director Government Medical Management
- Dan Barnett, MD Medical Director, Medical Risk Management
- John Wright, MD - Chair Regional Medical Director (Middle)
- Robert Yates, MD Regional Medical Director (West)
- Betty Emmert, RN Medical Policy Research Consultant
This site contains two types of health content: 1) proprietary information created by internal staff at BlueCross BlueShield of Tennessee and 2) licensed content from an external source.
Sources of health content are verified and stated on the site. Where health content is based on clinical experience or scholarly research, the actual author of the content will be stated. The credentials of the author will be placed on the Web site following the content, along with the author’s name and date. Any health professionals interacting with users on the site must meet credentials requirements.
Any self-assessment tool on the site will include proper documentation, such as the source, scientific basis for its operation, how the tool is maintained on the site, and the date of last update or review, all of which will be stated on the site.
All claims of therapeutic benefit stated on the site must go through this review process before appearing on the site in order to ensure that there is a reasonable basis for these claims. Ads or sponsored health content programs will go through a review process to show that the site is not accepting false or misleading information or promoting ineffective or dangerous products.
All content is reviewed at least annually. Outdated content is updated or removed from the site.
The medication formulary represents safe, cost-effective drugs expected to produce desired goals of therapy at a reasonable cost. It is
Members are informed of the
The BlueCross BlueShield Pharmacy and Therapeutics (P&T) Committee considers FDA-approved drugs for inclusion in the formulary. The P&T Committee consists of pharmacists and physicians, some of whom are community practitioners. The evaluation includes a literature review, and expert opinion may be sought. Formal reviews are prepared and typically address the following information: Effectiveness, safety, comparison studies, approved indications, adverse effects, contraindications, pharmacokinetics, patient administration/compliance considerations, medical outcome and pharmacoeconomic studies, and cost.
When a new drug is considered for formulary inclusion, an attempt will be made to examine the drug relative to similar drugs currently on formulary. Drugs reviewed by the P&T Committee are typically assigned to either Tier 2 or Tier 3, considering cost and clinical usefulness of the product. In addition, entire therapeutic classes are periodically reviewed. The class review process may result in a tier change for a specific drug.
The decisions of the P&T Committee may be communicated after each meeting in the provider newsletter BlueAlert, specialized mailings, or on www.bcbst.com. Pharmacy Management oversees the printing of the medication formulary and Prescribing Guidelines.
Review of the medication formulary occurs no less than annually and when new medical information becomes available. Drug classification, availability, and tier placement are subject to change. All of the material on the site related to the formulary is provided as a reference for drug therapy selection. The final choice of specific drug selection for an individual member rests solely with the prescriber.
BlueCross BlueShield of Tennessee currently does not accept advertisements from outside entities on its site. Any future advertising placed on the site would be distinguishable from health content either by words or by design. Any financial relationships with a linked site, including in-kind services other than reciprocal linking, will be stated and described on the site.
We encourage feedback from users of our site. A feedback form is available in the Contact Us section of the site for you to make suggestions or comments about your experience with the site that we will utilize for site evaluation purposes and for planning future improvements and functionality