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Commercial Behavioral Health Network

BlueCross BlueShield of Tennessee is committed to ensuring our members receive quality services from a network of dedicated health care professionals. One way we deliver on this commitment is to build, maintain and provide excellent service to a network of providers who can meet the many, and often complex, health care needs of our members.

To continue providing the highest quality and value to our members who require care from behavioral health providers, BlueCross will now directly contract all behavioral health providers.

As of Jan. 1, 2016, all behavioral health providers treating BlueCross members will be credentialed and contracted with BlueCross.

Frequently Asked Questions are also available.

Transition of Care

We have plans in place to ensure our members have access to the behavioral health care they require. Providers who choose not to contract directly with BlueCross will be required to care for our members for a 120 day transition period or until members complete their episode of care, whichever is shorter. During this time, all claims will continue to be paid at providers’ previous in-network rates and automatically processed at each member’s in-network benefit levels.

Following the transition period, members who receive care from non-BlueCross behavioral health providers will be subject to out-of-network benefits, rates and coinsurance as specified by their plans.

New MCG® Behavioral Health Care Guidelines

The MCG Behavioral Health Care Guidelines are evidence-based clinical guidelines that facilitate the appropriate level of care, more accurately manage episodes of care and help enhance the discharge planning process.

Adopted MCG Guidelines for Mental Health and Substance Use include:

  • Inpatient – Adult/Child/Adolescent
  • Residential – Adult/Child/Adolescent
  • Partial Hospital – Adult/Child/Adolescent
  • Intensive Outpatient – Adult/Child/Adolescent
  • Psychological Testing

Modified/New MCG Guidelines include:

  • Eating Disorder add-on criteria for all Eating Disorder Levels of Care
  • Detox add-on criteria specific to pregnant women

Behavioral Health Contacts

Should you have questions, please contact the appropriate regional network manager.

East Knox Region
Brenda Simmons
Network Manager
(865) 588-4631

Middle Region
Lee Green
Network Manager
(615) 483-7886

East Chattanooga Region*
Michael Burks
Network Manager
(423) 535-5880

West Region
Phillip Gomez
Network Manager
(731) 664-4122

Middle Region*
Jennifer Ramsden
Network Manager
(423) 535-3807

Upper East Region*
Catherine Overstreet
Network Manager
(423) 535-6013

*These network managers support adjoining regions and may be assigned as needed to best meet your needs.


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