Insurance Coverage Made Simple

Easily find out if your insurance plan is accepted at our clinic.

Accepted Insurance Plans

Disclaimer: The information provided is not all inclusive. Please contact each payer for product participation and patient benefits.
Please check your practice payer grids for credentialing approval per carrier. Your payer grid supersedes this list. Last updated 11/14/24

Contracted Payers

Payer Name	Type of Payer	Participating Products (PAR)	Non-Participating Products (NON-PAR)
ACS US Department of Labor	Workers Compensation	Black Lung Energy FECA	None
Aetna Healthcare	Commercial EPO - Elect Choice HMO MC-Managed Choice PPO	Aetna Choice POS Aetna Choice PPO Aetna Health Network Option Aetna HealthFund Health Reimbursement Arrangement Aetna HealthFund Health Savings Account Aetna Limited Benefits Insurance Plan (PPO) Aetna Open Access Elect Choice Aetna Open Access HMO Aetna Open Access Managed Choice Aetna Select Aetna Signature Administrators Aetna Student Health Aetna Voluntary Group Medical Plan (indemnity) Correct Care Solutions (Through Multiplan)\ Elect Choice Federal Service Benefit Plan HMO Joint claims administration Managed Care POS Managed Choice POS Medicare Advantage Plans Medicare Advantage PPO with Extended Service Area Plan (ESA) Meritain/Meritain shared administrative services National Advantage Program Open Access Aetna Select Passport to Healthcare PPO Premier PPO Quality Point-of-Service (QPOS) Signature Administrators Network Traditional Choice UAW Retirees	Aetna Choice POS II (Some radiologists are in network and some former STMP physicians only -- call to verify. Aetna states there is a crosswalk to Commercial HMO plans but it is all in the patient benefits if this product will be PAR or NON-PAR.) Aetna National Exchange Meritain Health -- Call to verify benefits on patient card (Meritain utilizes Aetna Choice POS II and some PPO Networks so it depends on patient's plan if in network or out of network) Premier Care Network (Radiologists only are contracted)
Align Network	Workers Compensation (Physical Therapy)	All lines of Business	None
Ambetter of TN	Commercial (Marketplace plan)	All lines of Business	None
Ambetter of GA Ambetter has reciprocity in place across all Ambetter networks in most states, including TN & GA. Members from either state can see any provider within Ambetter network and will have an in-network status. Claims will be processed in-network through the home state of the member's plan, not the state the patient is having services rendered.	Commercial (Marketplace plan)	All lines of Business	Ambetter of GA Ambetter has reciprocity in place across all Ambetter networks in most states, including TN & GA. Members from either state can see any provider within Ambetter network and will have an in-network status. Claims will be processed in-network through the home state of the member's plan, not the state the patient is having services rendered.
Anthem BCBS of GA (GA Locations Only - Effective 2021.09.30 (For TN Locations, claim will go through local BCBS)	Commercial -- Processessed through local BCBS	Blue Open Access HMO/POS BlueChoice HMO/POS BlueChoice PPO Pathway HMO Pathway Guided Access HMO Pathway Enhanced HMO/POS Medicare Advantage HMO Medicare Advantage PPO	Anthem Lumenos PPO Anthem Lumenos Open Access POS Blue Essential PPO Blue Essesntial Open Access POS
Anthem BCBS of KY (KY Locations Only) (For TN Locations, claim will go through local BCBS)	Commercial -- Processessed through local BCBS KY Medicaid	Exchange PPO & HMO HMO KY Medicaid PPO Traditional	Medicare Advantage HealthLink
Ascension Care Management (Formerly Mission Point Health Partners)	Non-Profit, Ministry Based Marketplace	Smart Health St. Thomas Rewards (HMO) St. Thomas Secure (HMO) St. Thomas Access (PPO) St. Thomas Access Plus (PPO)	2023.01.01 Termination of Clover Medicare Advantage 2024.01.01 Termination of Ascension Complete 2025.01.01-Termination of Ascension Personalized Care TN
Blue Cross Blue Shield of TN	Commercial Medicare Medicaid Marketplace Plans	Commercial Plans (PPO & EPO) Network P Network S Federal Plans Processed under Network P plans Marketplan Plans Bronze Silver Gold Medicaid Plans BlueCare Tennessee (MCO) BlueCare (HMO) CHOICES Employment & Community First CHOICES (ECF) TennCare Select (HMO Self-Insured by State - Enrollees cannot choose - Division of TennCare will enroll) CHOICES Employment & Community First CHOICES (ECF) Select Kids CoverKids (under age 19) Medicare/Medicaid Plans Dual Eligible Special Needs Plan (DSNP) BlueCare Plus (DSNP) Medicare Advantage Plans BlueAdvantage PPO Diamond Garnet Ruby Sapphire	2016.12.31 (Terminated) Network E -- Dropped from Exchange as of 12-31-2016 for the following counties: Middle-TN: Montgomery, Robertson, Cheatham, Sumner Trousdale, Davidson, Wilson, Williamson, and Rutherford for members that live in those counties. Memphis: Shelby, Fayette, Tipton, Haywood, and Lauderdale for members that live in those counties. 2018.12.31 (Terminated) BlueChoice HMO/BlueChoice HMO Medicare Advantage 2021.12.31 Terminated - Plan Discontinued BlueEssential MA HMO Network (C-SNP) (Diabetic patients who qualify for Medicare) (Also called BlueCare Plus) 2022.01.03 Network L -- ADI Out of Network Best Practice Network SelectCommunity Network 2023.01.01 Network E -- ADI is out-of-network
Bridges to Care	Charity program for Davidson Co residents	All lines of Business	None
CareSource of GA Effective 2021.04.20	Medicaid	All lines of Business	None
Center Care	TPA	All lines of Business	None
Cigna	Commercial Marketplace Plans	Choice Fund Choice Fund OAS Choice Fund OA Plus Cigna Bronze Cigna Care Network Cigna Gold Cigna Silver CONNECT -- See Tennessee Connect GWH-Cigna HMO Indemnity LocalPlus -- St. Thomas facilites only Open Access Plus POS Open Acces PPO SureFit Tennessee Connect (Exchange plan - Replaced EPO Connect) Effective 01/01/22 (Member can be serviced by any provider regardless of area)	2021.12.31 EPO Connect --replaced by Tennessee Connect Effective 2022.01.01 (Member can be serviced by any provider regardless of area) LocalPlus -- HCA facilities not in network
Cigna Medicare Advantage (Moving to HCSC in 2025) (Formerly known as Healthspring - bought out by HCSC. Will have a new name 1st Quarter of 2025)) **ALL plans have NO REFERRALS REQUIRED, however, Prior Authorization requirement stays in place and is required**	Medicare Advantage	Advantage (MA Only) - Does not include Part D Prescription drug) coverage CH-S Core Physicians DeKalb Independent IPODs North POD Preferred Plus Direct Preferred HMO Premier HMO Premier Plus South POD Synergy IPAs Total Care (Typically dual eligible members, Medicare Medicaid) True Choice PPO Vanderbilt Medical Group	2021.12.31 Synergy PSP Plan -- Cigna discontinued this plan and cross walked members to the Preferred Plan. 2021.12.31 Alliance Direct -- Plan discontinued
Cigna Medicare Advantage -- Premier IPA, LLC (Formerly known as Healthspring)	Medicare Advantage	Premier IPA, LLC	None
Cigna Medicare Advantage -- Rutherford County Physicians' Network, LLC (Formerly known as Healthspring)	Medicare Advantage	Rutherford CountyPhysicians' Network, LLC	None
Cigna Medicare Advantage -- - Synergy Healthcare, LLC (Formerly known as Healthspring)	Medicare Advantage	Synergy Healthcare, LLC	None
CorVel	Workers Compensation	All lines of Business	None
Devoted Health	Medicare Advantage	All lines of Business	None
Farm Bureau Advantage (See UHC/UMR)	Commercial -- See UHC/UMR	Commercial - UHC Choice Plus Network/UMR	Medicare Advantage pulling out of the TN Market effective 1/1/25
Health One Alliance & Alliant Health Plans (GA Plan only) Eff. 07/16/2022	Commercial/TPA	All lines of Business	None
Healthscope Benefits	Commercial	All lines of Business	None
Humana	Commercial Medicare	ASO PPO, POS, EPO ChoiceCare HMO Wrap Commercial - PPO, PFFS, HMO, CPOS, EPO ChoiceCare Medicare HMO ChoiceCare Medicare PFFS ChoiceCare Medicare PPO/POS Humana Choice Care Humana CPOS (Choice POS) Humana Gold Choice - Medicare HMO Humana Gold Plus-Medicare HMO Humana National PPO Plus Knoxville PPOx Medicaid Medicare - PPO, PFFS, HMO Memphis PPOx Nashville PPOx National POS	HMO Premier Open Access
Humana Military Healthcare Services (Tricare East)	Military - Tricare East	Tricare for Life (MedicareAdvantage Plan) Tricare Prime Tricare Prime Remote Tricare Reserve Select Tricare Retired Reserve Tricare Standard Tricare Standard and Extra Tricare Young Adult	Tricare Prime Overseas Tricare Prime Remote Overseas Tricare Standard Overseas US Family Health Plan
MedFin (Contracted and Credentailed per individual provider if approved by MedFin)	Medical Lien Purchase & Servicing Agreement	All lines of Business	None
Medicaid of Kentucky-Aetna Better Health (Formerly Coventry Cares of KY)	Medicaid	KY Medicaid MCO	None
Medicaid of Kentucky-Humana Care Source	Medicaid	KY Medicaid MCO	None
Medicaid of Kentucky-KY Health Choices (Traditional)	Medicaid	Traditional KY Medicaid	None
Medicaid of Kentucky-Passport Health	Medicaid	KY Medicaid MCO	None
Medicaid of Kentucky-Wellcare	Medicaid	KY Medicaid MCO	None
Medicare-CGS (KY MAC)	Medicare	Traditional Medicare	None
Medicare-Palmetto (TN/GA MAC)	Medicare	Traditional Medicare	None
Medicare-Railroad (TN/GA)	Medicare	Railroad Employees	None
MedRisk Inc.	Workers Comp-Physical Therapy	EMG - Electrodiagnostic Services	None
MoveDocs (Formerly known as Key Health) (Contracted and Credentailed per individual provider if approved by MoveDocs)	Medical Lein Purchase and Servicing Agreement	All lines of Business	None
MultiPlan / PHCS / Beech Street	TPA Workers Compensation	All lines of Business	None
NovaNet Network (Not NovaNet PPO Payer)	Workers Compensation	All lines of Business	(Not the PPO plan)
Odyssey Healthcare	Therapy Services	All lines of Business	None
Oscar	Commercial Marketplace Plans	Secure - Simple Bronze - Simple, Classic, Classic Next, Saver Silver - Simple, Classic, Classic Next, Saver Gold - Classic Silver (CSR) Simple - CSR 250, CSR 200, CSR 150 Classic - CSR 250, CSR 200, CSR 150 Classic Next - CSR 250, CSR 200, CSR 150 Saver - CSR 250, CSR 200, CSR 150 Silver -- Classic	None
PeachState of GA	Medicaid	All lines of Business	None
Prime Health Services	TPA	All lines of Business	None
Sedgwick	Workers Compensation	All lines of Business	None
Signature Advantage (Plan begins 01/01/2023)	Medicare	All lines of Business	None
TennCare	Medicaid	TN Medicaid	None
Tennessee Breast & Cervical CA Screening	Breast and Cervical CA Screening Program	Davidson County Mid-Cumberland	None
United Healthcare	Commercial Marketplace Plans	AARP AARP HMO AARP Medicare Advantage Patriot AARP Medicare Advantage Plan 1&2 - AARP Medicare Advantage Walgreens PPO AARP Medicare Complete HMO Choice POS Choice PPO Medicare Advantage (East TN) Choice Plus Choice Plus Network - Surest Plan Core Core Choice Plus Core Essential Dual Complete Farm Bureau Commercial - Card will say UMR/UHC Choice Plus Network GEHA Golden Rule HCA Employee Benefits Plan -- Choice Plus Plan Heritage Plus Heritage Select Advantage Individual Exchange Benefit Plans (Formerly known as Compass) Exchange Plans: Value Gold Balance Plus Silver Balance Silver Value Silver Value Bronze Saver Balance Bronze Navigate Network River Valley Choice Plus PPO Secure Horizons, Medicare Advantage-AARP Product Veterans Community Care Network (VACCN) (cannot opt out)	2021.12.31 Compass - Payer discontinued on 12/31/21 and replaced with Individual Exchange Benefit Plans effective 01.01.2022 (UHC accidently terminated early on 12/09/21 -- UHC fixing problem for overall claims and authorizations) All Savers -- Call to verify benefits on patient card to see if provider is in-network or out-of-network
United Healthcare Community Plan	Medicaid	CoverKids River Valley Dual Complete (HMO) UHC Dual Complete ONE Plan (HMO)	None
USA MCO	Commerical Workers Compensation	All lines of Business	None
Wellcare of GA	Medicare	All lines of Business	None
Wellcare of TN	Medicare	Access HMO SNP Advance HMO Dividend HMO-POS Rx HMO Value HMO	None
Wellpoint Formerly Amerigroup of TN	Medicaid Medicare	Amerivantage Balance Plus (HMO) Amerivantage Classic + RX Plan Amerivantage Classic Plus (HMO-POS) Amerivantage Specialty + Rx Plan CoverKids TennCare TennCare Plus	None
Wellpoint of GA Formerly Amerigroup of GA	Medicare Medicaid	All lines of Business	None
Work Well Physical Medicine	Workers Compensation	All lines of Business	None

Non-Contracted Payers

Alliant Health Plans (See Health One Alliance)

Altrua Healthshare

Amedisys

American Healthcare Alliance

Any Out-of-State BCBS Plan -- Claims are filed with local BCBS of TN. (Pre-Certs/Prior Authorizations will be out of network)

Assurant Health

ATRIO Medicare Advantage

Baptist Health Plan (Formerly BlueGrass Family Health Plan)

Bright Health (Out of business 12.31.2022)

Care Improvement Plus

Celtic (Centene)

Cigna Priority Health Plan (Michigan) -- Should be filed through local Cigna office

Clover Health (Payer terminated plan due to low membership 12.31.2022)

Core Civic (Formerly Inmate Health Services)

Coventry-Commercial and Workmen's Comp

Coventry-First Health

Empire (UHC New York)

First Health (See Coventry)

Friday Health Plans

GHI

Healthcare Networks of America

Healthcare Solutions

Health One Alliance -- Only Chattanooga and GA Providers are Enrolled and Effective

Inmate Health Services

Kaiser Health

Kentucky Health Cooperative (liquidated 2016)

Liberty Healthshare

Medi Cost Pro

Medi-Share (If processed through PHCS, ADI accepts)

Novanet PPO (payer)

Olympus

Omni Healthcare

Partners Direct Health

Point Comfort Underwriters

Progyny

Rhythm Health

Solidarity Healthshare

United Healthcare Community Plan of Kentucky (MCO): : In Process. As of 2022.01.01 ADI is out of network

UPMC (University of Pittsburgh Medical Center)

Veterans Evaluation Services

Our Commitment to Excellence

Committed to personalized, comprehensive women’s health care.
Recognized leaders in women’s health in Hendersonville.
Continuously advancing to deliver the best patient outcomes.

Pregnant couples in a prenatal class setting.

Your Health, Our Priority

Choosing the right OBGYN team is crucial for your health and peace of mind.

Book an Appointment