Medical Billing Services in Tennessee
Remote medical billing and revenue cycle management for Tennessee practices that bill TennCare, Medicare, Medicare Advantage and commercial plans such as BlueCross BlueShield of Tennessee. Cleaner claims, fewer denials and faster payments, with no upfront cost.
A billing team that knows Tennessee payers
TennCare has run entirely through managed care for decades, with members assigned to a handful of statewide health plans. BlueCross BlueShield of Tennessee leads the commercial market, and Cigna has a large presence around Nashville.
Provider Concerns handles that work for you, remotely. Our team verifies coverage and plan type before each visit, codes and scrubs every claim, submits it electronically, posts payments and works every denial by reason code. You get a single point of contact and monthly reports on collections, denials and days in A/R, so you always know where your revenue stands.
We work with solo physicians, specialty groups, clinics and multi-location practices across Tennessee, including Nashville, Memphis, Knoxville, Chattanooga, Clarksville and Murfreesboro. Because we work inside your existing EHR or practice management system, there is nothing to install and no disruption to your front desk. Learn more about our medical billing, denial management, claims processing and revenue cycle management services.
What we handle for Tennessee practices
- Medicare Part B claims through Palmetto GBA (Jurisdiction J)
- TennCare claims, mostly through managed care plans
- Medicare Advantage plans, with plan-level authorization tracking
- Commercial payers such as BlueCross BlueShield of Tennessee, UnitedHealthcare and Cigna
- DME claims to CGS (DME Jurisdiction C)
- Eligibility checks, coding review, A/R follow-up and patient statements
- Monthly reporting on collections, denials and days in A/R
Tennessee billing rules at a glance
The payer rules that shape how Tennessee claims get paid. Plan contracts can differ, so we confirm each payer's current requirements during onboarding.
Medicaid program
TennCare, paid mostly through managed care plans
Medicaid filing limit
Set by the state program and by each managed care plan contract; we confirm every payer's current window during onboarding
Medicare contractor (Part A/B)
Palmetto GBA, Jurisdiction J
Medicare filing limit
12 months (one calendar year) from the date of service
DME contractor
CGS (DME Jurisdiction C)
Major commercial payers
BlueCross BlueShield of Tennessee, UnitedHealthcare, Cigna, Aetna and Humana
Revenue cycle services for Tennessee practices
Pick one service or hand us the whole revenue cycle. Either way, you keep full visibility into every claim.
Medical billing
Charge entry, claim scrubbing and electronic submission to every Tennessee payer you work with.
Learn more →Claims processing
Clean claims built to each payer's edits, so fewer are rejected before they are ever reviewed.
Learn more →Denial management
Every denial worked by reason code, corrected, appealed and tracked until it is paid.
Learn more →Revenue cycle management
Eligibility, coding review, payment posting, A/R follow-up and monthly reporting in one service.
Learn more →Common Tennessee denials and how we prevent them
Most denials are preventable. These are the ones we see most often for Tennessee practices, and the checks we run to stop them before a claim goes out.
Wrong Medicaid plan
Tennessee Medicaid members can switch managed care plans, and claims sent to the old plan are denied. We re-check plan assignment before each visit and on every rejected claim.
Medicare Advantage vs. Original Medicare
Patients move between Original Medicare and Medicare Advantage plans during open enrollment. We verify the plan at every visit so claims don't go to Palmetto GBA when a private plan should be billed.
Missing prior authorization
Many Tennessee plans require approval for imaging, procedures and specialty visits. We request and track authorizations before the date of service.
Coding and modifier errors
Bundling edits, missing modifiers and diagnosis codes that don't support medical necessity are among the most common avoidable denials. Certified coders review claims before they go out.
Timely filing
Medicare, TennCare and commercial plans each set different deadlines. We track every open claim against its payer's window so nothing ages out.
Coordination of benefits
Secondary coverage, workers' comp and auto claims need the right payer order. We confirm it up front and bill secondary payers as soon as the primary pays.
Getting started is simple
No long setup and no upfront cost. Here is how Tennessee practices move their billing to Provider Concerns.
Free billing review
We look at your collections, denials and A/R to find where revenue is being lost.
Payer setup
We confirm your TennCare, Medicare and commercial enrollments and each payer's rules.
Clean claims
We verify eligibility, code, scrub and submit claims inside your current system.
Follow-up & reports
Denials and aging balances are worked every week, with monthly reporting.
Medical billing across Tennessee
We support practices statewide, from large metro groups to rural clinics. Billing is handled online, so location is never a barrier.
Specialties we bill for in Tennessee
Frequently asked questions about medical billing in Tennessee
Do you bill TennCare?
Who is the Medicare contractor for Tennessee?
Which commercial insurance plans do you work with in Tennessee?
Can you support practices in Nashville and other Tennessee cities?
What is the Medicaid timely filing limit in Tennessee?
How much does medical billing cost for a Tennessee practice?
Ready to get paid faster in Tennessee?
Get a free billing review. We'll look at your collections, denials and A/R and show you exactly where revenue is being lost.