Medical billing services in Tennessee
Billing, coding, credentialing and A/R follow-up for providers in Tennessee.
Billing in Tennessee: what is different
TennCare is delivered entirely through managed care organizations.
Key payers and contractors in Tennessee
- Medicare Part A/B
- Palmetto GBA, Jurisdiction JJPortal: Palmetto GBA eServices
- Medicare DME
- CGS, DME MAC Jurisdiction CDME supplier claims only · Portal: myCGS
- Medicaid
- TennCare
- Blue Cross Blue Shield
- BlueCross BlueShield of Tennessee
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Tennessee providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Palmetto GBA through Palmetto GBA eServices
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Tennessee: common questions
Do you bill TennCare?
Yes. TennCare is delivered entirely through managed care organizations, so we confirm the patient’s assigned MCO for the date of service and bill that plan under its own authorization rules.
Who processes Medicare claims in Tennessee?
Medicare Part A and B claims in Tennessee are processed by Palmetto GBA (Jurisdiction JJ), and we submit and track them through Palmetto GBA eServices. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction C), through myCGS.
Can you credential new providers in Tennessee?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Tennessee.
Neighboring states and key payers
Get a free billing audit for your Tennessee practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.