Reliable Medical billing services in Tennessee
SwiftCare Billing provides medical billing services in Tennessee for practices that want claims paid on time. We bill TennCare and its three health plans, Medicare through Palmetto GBA, and commercial carriers like BlueCross BlueShield of Tennessee. Pricing starts at 3% of collections. Month-to-month, 30 days’ notice.
- 98.4% Clean Claim Rate
- 175+ Providers
- 50+ Specialties
- 12+ Years
Tennessee billing facts you should have on hand
| Item | Tennessee |
|---|---|
| Medicaid program | TennCare, run by the Division of TennCare (Department of Finance and Administration) |
| Health plans | BlueCare Tennessee, UnitedHealthcare Community Plan, Wellpoint Tennessee (plus TennCare Select) |
| Provider registration | TennCare provider registration (PDMS portal) |
| Medicare A/B contractor | Palmetto GBA, Jurisdiction J (also Alabama and Georgia) |
| Medicare DME contractor | DME MAC Jurisdiction C |
| Medicare timely filing | 12 months from date of service |
| TennCare timely filing | 120 calendar days from date of service; exceptions exist |
| Commercial prompt pay | 21 days electronic, 30 days paper; 1% monthly interest if late (T.C.A. 56-7-109) |
| Surprise billing | Federal No Surprises Act, plus a state notice rule for facility-based physicians |
| Workers’ compensation | Medicare-based fee schedule with Tennessee conversion percentages; reset each April 1 |
Where Tennessee claims go wrong
Three Medicaid plans, three rulebooks
Tennessee doesn’t have a dozen Medicaid plans. It has three, and each one runs its own authorizations and claim edits. That sounds simple until a patient switches plans and nobody tells the front desk. We confirm the plan before every visit, so claims go to the right place the first time.
The 120-day TennCare window
TennCare claims generally have to be filed within 120 calendar days of the service date. If a patient gets retroactive coverage, the clock can start on a different date, based on when eligibility was reported. Mixing up the two is how good claims turn into write-offs. We track both dates.
Facility-based doctors need a signed notice.
Anesthesiologists, radiologists, and similar physicians who work in network hospitals face a state rule. Under T.C.A. 56-7-120, a carrier can refuse payment to an out-of-network facility-based physician who didn’t get the patient’s signed written notice beforehand. We check that the notice exists before the claim goes out.
Workers' comp rates changed on April 1
Tennessee’s workers’ comp fee schedule is built on Medicare, with state conversion percentages, and the rate tables reset each April 1. Payers can’t pay above the maximum without a waiver. The 2026 tables took effect on April 1, 2026. We price every work injury claim against the current table.
- Our Services
Medical billing services in Tennessee
that cover every step of the claim
Think of us as a medical billing agency in Tennessee that works inside your system. We handle the full cycle, or any single step. That includes medical billing and coding services in Tennessee from AAPC-certified coders, so you don’t need a separate coding vendor.
We confirm the exact TennCare plan, not just active coverage
Codes checked against Palmetto GBA edits and each plan’s rules
Claim submission
Claims scrubbed first, then tracked to payment
Each denial logged by payer and reason, then fixed at the source
Oldest claims first, with the 120-day TennCare limit in mind
Payments posted; plain-language statements
Requests tracked plan by plan
Outsourced medical billing company for Tennessee practices
As an outsourced medical billing company, we take the whole workflow off your desk. You send encounters. We return paid claims, denial reports, and a monthly summary. You get one named account manager, not a ticket queue. For many clinics, medical billing outsourcing in Tennessee means one fewer hire to manage.
Physician medical billing services in Tennessee
Our physician medical billing services suit solo doctors and groups alike. We know that small practices don’t have spare staff, and larger ones just want fewer rejections.
Medical claims billing services in Tennessee
If you only need claims handled, that works too. We scrub, submit, and follow up. You stay in control of everything else.
Revenue cycle management services in Tennessee
Our revenue cycle management services in Tennessee start at the front desk, where most denials begin. Clean registration and verified eligibility cut rework later. Professional medical billing services should do more than send claims, and we look at the whole cycle.
TennCare enrollment and payer credentialing
No enrollment, no payment. You register with TennCare first and get a Medicaid ID. Then each health plan credentials you on its own. Our medical credentialing services cover all of it, plus Medicare and commercial plans.
- NPI check and an attested CAQH profile
- Medicare enrollment through PECOS, processed by Palmetto GBA
- TennCare provider registration
- Credentialing with BlueCare, UnitedHealthcare Community Plan, and Wellpoint
- Commercial plan applications, including BlueCross BlueShield of Tennessee
- Revalidation reminders
The payers behind your Tennessee claims
We bill TennCare plans, Medicare and Medicare Advantage, and commercial carriers. Tennessee practices comparing medical billing service providers often ask about the best medical billing company in Tennessee for their size. Here’s how to compare medical billing companies in Tennessee.
Who pays, and how long they have:
| Coverage | Rule that changes your billing |
|---|---|
| TennCare plans | File within 120 days; the state tracks plan payment speed |
| Medicare | File within 12 months |
| Commercial | Paid in 21 days (electronic) or 30 (paper), or 1% monthly interest |
| Out-of-network facility-based care | Signed patient notice before service |
| Workers’ comp | Medicare-based schedule; rates reset each April 1 |
Specialties our Tennessee clients practice.
We bill 50+ specialties. Tennessee practices often come to us in family practice, pediatrics, mental health, physical therapy, chiropractic, and cardiology. These medical practice billing services also suit practices with work injury patients.
Your EHR, not ours
We support 80+ systems and work inside yours: Epic, athenahealth, eClinicalWorks, Tebra (Kareo), and AdvancedMD are a few. Nothing to migrate, nothing to retrain. We connect to your clearinghouse and TennCare’s systems.
From Memphis to Knoxville
Memphis, Nashville, Knoxville, Chattanooga, Clarksville, Murfreesboro, Franklin, Johnson City, Jackson, and Cookeville, plus the small towns between. SwiftCare Billing serves providers in all 50 states.
Why a Tennessee practice would pick SwiftCare Billing
- Fewer denials. Our clean claim rate is 98.4%.
- Trained people. 200+ certified billers and AAPC-certified coders, all U.S.-based.
- Someone to call. A named account manager handles your account.
- Honest pricing. From 3% of collections, with no long-term contract.
- Numbers you can use. Monthly reports on collections, denials, and A/R.
- No new software. We log into your EHR.
- A short ramp. Go-live takes 7 to 14 business days.
- A free first look. Your audit report arrives in 5 business days.
Keeping patient data protected
Before we open a single record, we sign a business associate agreement with you. HIPAA requires one (45 CFR 164.504(e)). If a breach ever occurs, we must tell you without unreasonable delay, and within 60 days of discovery at the latest (45 CFR 164.410). Your agreement may set a shorter deadline. Staff sees only the data a task needs, and your records are yours if you leave.
Proof points, not promises
98.4% clean claim rate across SwiftCare Billing clients
Onboarding in 7 to 14 business days
Free audit report in 5 business days
What you'll pay
Pricing starts at 3% of collections. Most practices pay 3% to 8%, based on specialty, claim volume, and payer mix. There’s no long-term contract, and you can leave with 30 days’ notice. See pricing. You’ll find affordable medical billing services for small practices, but the audit tells you the real number.
Starting with us: the first two weeks
1. Send recent claims; we return a written audit in 5 business days.
2. Give us access to your EHR and clearinghouse.
3. We check enrollment with Palmetto GBA, TennCare, and each plan.
4. We review your fee schedules and contracts.
5. You go live in 7 to 14 business days; monthly reports follow.
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Questions Tennessee practices ask us
How much does medical billing cost in Tennessee?
Pricing starts at 3% of collections. Most practices pay 3% to 8%. A free audit gives you a quote based on your own claims.
Which TennCare plans do you bill?
BlueCare Tennessee, UnitedHealthcare Community Plan, and Wellpoint Tennessee. We also handle credentialing with each one.
Who processes Medicare claims in Tennessee?
Palmetto GBA, as the A/B MAC for Jurisdiction J. DME claims go to DME MAC Jurisdiction C. Medicare claims must be filed within 12 months.
How long do I have to file a TennCare claim?
Generally, 120 calendar days from the date of service. Exceptions exist, such as retroactive eligibility, where the start date can differ.
How fast must Tennessee insurers pay claims?
Insurers must pay, deny, or request more information within 21 days for electronic claims and 30 days for paper. Late payments accrue 1% interest per month.
How does workers' comp billing work in Tennessee?
Fees follow a Medicare-based schedule with Tennessee conversion percentages, and the rates update each April 1. Payers can’t pay above the maximum without a waiver.
Do you sign a business associate agreement?
Yes, before we access any records. HIPAA requires it, and it sets breach-notice terms.
Can you work inside our EHR?
Yes. We support 80+ systems, and you keep yours.