Medical Billing Built for Tennessee Healthcare Providers
TennCare, launched January 1, 1994, was the first state Medicaid program in the country to move its entire Medicaid population into managed care, and it still operates today under a Section 1115 demonstration waiver rather than a standard state plan — a structure genuinely different from most states' Medicaid programs. Coverage runs through three MCOs: BlueCare Tennessee, Amerigroup Tennessee, and UnitedHealthcare Community Plan. Tennessee has not adopted the ACA's Medicaid expansion, which keeps eligibility rules narrower than in expansion states. Tennessee also has a specific, real prompt-pay statute — Tenn. Code Ann. § 56-7-109 — requiring health insurers to pay or deny a clean claim within 21 calendar days for electronic submissions or 30 calendar days for paper, with 1% monthly interest owed on anything paid late. And BlueCross BlueShield of Tennessee, headquartered in Chattanooga, is the dominant commercial payer statewide, so its documentation and modifier rules matter more here than in most states.
Whether you're in Memphis, Nashville, Knoxville or anywhere else in Tennessee — ZenoMedix RCM provides the same certified billing expertise with deep knowledge of local payer rules and Tennessee Medicaid requirements.
Major Payers We Work With in Tennessee
Tennessee Medicaid
TennCare — Tennessee's statewide Medicaid managed care program, in continuous operation since January 1, 1994 under a Section 1115 waiver, delivered through three MCOs: BlueCare Tennessee, Amerigroup Tennessee, and UnitedHealthcare Community Plan. Tennessee has not adopted the ACA's Medicaid expansion.
HIPAA Compliance
Full HIPAA compliance for all TN providers. We stay current with all Tennessee billing regulations. View HIPAA Statement →
Every City in Tennessee — We're Your Billing Team
Remote billing means you get the same expert service whether you're in a major metro or a smaller community across Tennessee.
75+ Specialties Served Across Tennessee
Each specialty has a dedicated billing team trained on its CPT codes, modifiers, and payer-specific requirements in Tennessee.
Everything Your Practice Needs — Nothing You Don't
Tennessee Billing FAQ
Yes. Because TennCare has run entirely through managed care since January 1994 under its own Section 1115 waiver, claims go to whichever MCO the patient is enrolled with — BlueCare Tennessee, Amerigroup Tennessee, or UnitedHealthcare Community Plan — rather than to a fee-for-service state Medicaid office. We confirm the correct MCO before submitting.
Under Tenn. Code Ann. § 56-7-109, Tennessee insurers must pay or deny a clean claim within 21 calendar days for electronic submissions or 30 days for paper, and owe 1% monthly interest on late payments. We track claim aging against that statute so late payments get flagged rather than written off.
Yes. BlueCross BlueShield of Tennessee, based in Chattanooga, is the dominant commercial payer in the state, and our Tennessee coding team bills it alongside UnitedHealthcare, Aetna, Cigna, and Humana, tracking each payer's documentation and modifier requirements so claims go out clean the first time.
It can. Tennessee has not adopted the ACA's Medicaid expansion, so TennCare eligibility categories are narrower than in expansion states — we verify eligibility against TennCare's actual categories rather than assuming standard expansion-state rules apply.
We serve Tennessee practices statewide, from Memphis, Nashville, Knoxville, Chattanooga, and everywhere in between, with the same certified coding team regardless of metro size.