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Radiology Billing Services in Tennessee

Built for Palmetto GBA’s three-state Jurisdiction J rules and TennCare’s three-MCO Medicaid program, we keep Tennessee radiology groups paid accurately and on time.

Radiology Billing Built For Tennessee's Realities

From Memphis to the Tri-Cities, Tennessee radiology groups bill against a three-state Medicare jurisdiction, a TennCare program split across three regional MCOs, and a state-sanctioned hospital monopoly found nowhere else we bill.

Jurisdiction J Medicare rules shared with Alabama and Georgia

TennCare Medicaid split across three managed care plans

A government-sanctioned hospital monopoly in Northeast Tennessee

1 percent monthly interest on claims paid late

Processed Claim Value
$ M+
Avg. A/R Collection Time
0 Days
Turn Around Time (TAT)
0 Hours
Client Retention Rate
0 %
Annual Claims
0 M+
First-Pass Claim Rate
0 %
Avg. Revenue Growth
8- 8 %
Avg. Denial Reduction
0 %

Tennessee's Regulatory Landscape

Tennessee radiology billing runs through a three-state Medicare jurisdiction, a Medicaid program split across three regional plans, and a strict monthly-interest prompt pay rule.

Jurisdiction J Medicare Rules

Palmetto GBA processes Medicare Part A and B claims for Jurisdiction J, covering Tennessee, Alabama, and Georgia. Local coverage determinations are set across all three states, so a policy update out of Georgia applies just as directly to a radiology group in Nashville. We track Palmetto’s specific bulletins so Tennessee claims match the standard actually enforced.

TennCare's Three-MCO Structure

TennCare, Tennessee’s Medicaid program, runs managed care through three plans organized by region: Wellpoint, BlueCare and TennCare Select, and UnitedHealthcare Community Plan, covering West, Middle, and East Tennessee differently. Imaging claims route through whichever plan and region a patient falls under, each with its own prior authorization rules a billing team has to track separately.

A 2017 Compact Member

Tennessee joined the Interstate Medical Licensure Compact in 2017, letting physicians already licensed in a member state fast-track a Tennessee license. The compact speeds up credentialing, but a separate payer enrollment is still required before claims can be billed under that radiologist’s NPI, a step that still catches practices off guard.

21/30-Day Prompt Pay Rule

Under Tennessee Code 56-7-109, health insurers must act on a clean electronic claim within 21 calendar days and a paper claim within 30 days, either paying it, paying the undisputed portion, or explaining what’s missing. Carriers that miss the deadline owe 1 percent monthly interest on the unpaid amount. We build Tennessee claims clean on the first pass so they clear inside that window.

Complete Radiology Revenue Cycle Management

Certified CIRCC and CPC coders handle every CPT code, modifier, and global billing rule specific to diagnostic and interventional radiology — maximizing reimbursement on every encounter across all modalities and payer types.

Where Tennessee Radiology Billing Breaks Down

A three-state Medicare jurisdiction, a Medicaid program split across three regional plans, and a monthly interest penalty on late claims all add friction most billing teams aren’t built to absorb.

Before RBS

TennCare claims denied for the wrong region's MCO rules

Jurisdiction J denials reworked from scratch every time

Compact licensing mistaken for payer enrollment

Electronic claims slipping past the 21-day deadline

Monthly interest penalties absorbed instead of collected

After RBS

TennCare claims matched to the correct region and MCO

Jurisdiction J appeals built on tracked Palmetto bulletins

Licensure and payer enrollment tracked as two separate steps

Every electronic claim timestamped against the 21-day deadline

Late-payment interest tracked and collected, not written off

Precision RCM & Coding Built for Radiology

Generic billing is the fastest way to a denied radiology claim. RBS delivers specialty-specific revenue integrity built for imaging’s TC/PC splits and modifier rules, so you capture every dollar you’re owed.

Diagnostic Radiology

CT Scan

MRI & MRA

Nuclear Medicine

PET / PET-CT

Ultrasound

Interventional Radiology

Teleradiology

Mammography

DEXA / Bone Density

Hospital Radiology

Radiation Oncology

Coverage Confirmed for Every Payer You Work With

From national carriers to regional Medicaid plans, coverage is checked against the exact payer, plan, and product type on file — never a generic match. Every result reflects current payer policy, not outdated data from months ago.
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana

Serving Radiology Practices Across Tennessee

From Nashville and Memphis to Knoxville, Chattanooga, and the Tri-Cities, we bill for radiology groups and their hospital partners across the state.

Nashville & Middle Tennessee

Cities
  • Nashville
  • Murfreesboro
  • Franklin
Counties
  • Davidson County
  • Rutherford County

Memphis & the Mid-South

Cities
  • Memphis
  • Bartlett
  • Germantown
Counties
  • Shelby County

Knoxville & East Tennessee

Cities
  • Knoxville
  • Oak Ridge
  • Maryville
Counties
  • Knox County
  • Blount County

Chattanooga & the Southeast

Cities
  • Chattanooga
  • Cleveland
  • East Ridge
Counties
  • Hamilton County
  • Bradley County

Tri-Cities & Northeast Tennessee

Cities
  • Johnson City
  • Kingsport
  • Bristol
Counties
  • Washington County
  • Sullivan County

Jackson & West Tennessee

Cities
  • Jackson
  • Dyersburg
  • Union City
Counties
  • Madison County
  • Obion County

Wired Into Every System You Already Run

Your EHR, RIS, and PACS stay exactly as they are. We plug our coding workflow directly into what you already use — no migration, no new login for your radiologists, no disruption to how your team already works.

Built for Tennessee's Dominant Private Payer

BlueCross BlueShield of Tennessee holds roughly 42 percent of the state’s commercial health insurance market, more than any other carrier operating here. A practice that can’t bill cleanly against BCBST is exposed on a large share of its commercial volume. We build every claim to clear its specific requirements the first time, rather than treating it like a generic national payer.
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Frequently Asked Questions

What Medicare Administrative Contractor handles Tennessee radiology claims?

Palmetto GBA processes Medicare Part A and B claims for Jurisdiction J, which also covers Alabama and Georgia. We track Palmetto’s specific billing bulletins rather than generic national Medicare guidance.
TennCare runs Medicaid through three plans organized by region: Wellpoint, BlueCare and TennCare Select, and UnitedHealthcare Community Plan, covering West, Middle, and East Tennessee differently. Which plan and region a patient falls under determines the prior authorization rules that apply.
No. Tennessee joined the Interstate Medical Licensure Compact in 2017, which speeds up getting a Tennessee medical license, but an out-of-state radiologist still needs that license and separate payer enrollment before claims can be billed under their NPI.
Ballad Health is a government-sanctioned hospital monopoly covering Northeast Tennessee, formed in 2018 under a state Certificate of Public Advantage that let two competing systems merge without antitrust review. With no competing health system in its region, billing accuracy against Ballad’s specific rules matters even more, since practices there have nowhere else to send a denied claim.
Yes. BCBST covers roughly 42 percent of the state’s commercial insurance market, so a large share of our clients’ claims run through it. We build claims to its specific requirements rather than treating it as a generic commercial payer.

Get Tennessee Radiology Billing That Keeps Up

From Jurisdiction J appeals to TennCare’s three-MCO structure, let’s talk about what’s actually slowing down your reimbursements.

Jurisdiction J and Palmetto-specific claim review

TennCare claims matched to the right region and MCO

Compact licensing and payer enrollment tracked end to end

Clean-claim tracking against the 21/30-day deadline

Commercial billing built for BCBST's specific requirements

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What Our Clients Say?

Rebecca Lawson

★★★★★

Radiology Practice Manager

Since partnering with your radiology billing team, our billing workflow has become much smoother. They understand imaging procedures, payer requirements, coding, and claim follow-ups. Their team is responsive, professional, and always stays on top of outstanding claims.

Dr. Christopher Bennett

★★★★★

Medical Director, Diagnostic Imaging Center

Your team truly understands the challenges of radiology billing. They handle claims accurately, follow up on unpaid accounts, and help resolve billing issues efficiently. Their expertise and communication have made our revenue cycle more organized and reliable.

Dr. Andrew Whitaker

★★★★★

Radiologist & Imaging Center Owner

Our team has been an excellent partner for our imaging center. They understand radiology billing, coding, claim submission, denials, and follow-ups. Their attention to detail and consistent communication have helped streamline our billing process and improve our revenue cycle.

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