The Best Medical Billing Company in Tennessee - Shoreline
Shoreline Medical Billing company delivers certified billing, AR recovery, and 96% clean claim rates to healthcare providers across Tennessee.
Comprehensive Medical Billing Services for Tennessee Practices
Navigating medical billing and revenue cycle management in Tennessee requires deep familiarity with TennCare (Tennessee Department of Finance and Administration), regional commercial payers (Blue Cross Blue Shield of Tennessee, TennCare (Tennessee Department of Finance and Administration), UnitedHealthcare, Humana, Aetna, Regional PPO/HMO Plans), and federal Medicare MAC (Palmetto GBA (Jurisdiction J-M)) guidelines.
Shoreline Medical Billing partners with physician practices, ambulatory surgery centers, physical therapy clinics, and specialized healthcare systems across Tennessee. Our certified billing teams eliminate claim backlogs, prevent timely filing write-offs, and accelerate monthly cash flow.
Best In The Industry
Shoreline medical billing services in Tennessee exceeds customer expectations and we are proud of our history, but more importantly we are focused on the future. We have grown in recent years by continuing to invest in technology and people while maintaining a commitment to excellent service and innovation. We have the best customer service and one of the highest success rates for reimbursement, so you know your money will be going where it belongs - back into your pocket.
Tennessee Healthcare Billing Challenges We Solve
TennCare Medicaid MCO Adjudication Quirks
TennCare operates entirely through managed care organizations including BlueCare, Amerigroup, and UnitedHealthcare Community Plan, each with divergent timely filing and billing rules. Shoreline synchronizes billing rules across all three MCOs.
Tennessee Prompt Pay Act Compliance & AR Recovery
Tennessee law requires clean claims to be paid within 30 days for electronic submissions. Our aging AR recovery specialists enforce prompt-pay statutory interest on delayed commercial payments.
Substance Use Disorder (SUD) & Behavioral Health Billing
Tennessee specialized behavioral health and addiction medicine programs face rigorous parity documentation and bundling guidelines. We manage complex multi-tiered therapy and MAT billing protocols.
Hospital-Physician Alignment & Credentialing Timelines
Onboarding physicians with Tennessee health systems and commercial payers often takes up to 120 days. We expedite CAQH re-attestations and payer enrollment to protect revenue during provider transitions.
Comprehensive Revenue Cycle Management Services for Tennessee
Specialized Services tailored to meet Tennessee's Medicaid rules and regulations
TennCare Medicaid Billing
Virtual Assistant for front-end management, real-time eligibility verification, and electronic claims submission through TennCare Medicaid portals.
TennCare MCO Network Billing
Unified billing workflows across BlueCare, Amerigroup Community Care, and UnitedHealthcare Community Plan of Tennessee.
Denial Management
AI tools to track denial patterns, payer-specific code analysis, and expedited appeal submissions for Tennessee claims.
Credentialing
Tennessee Board of Medical Examiners licensing, TennCare Medicaid provider enrollment, and CAQH profile maintenance.
Patient Statements & Follow-Up
Clear Explanation of Benefits (EOB) communication, automated statement generation, and respectful patient financial follow-up for Tennessee practices.
Practice Revenue Audits
100% chart-to-claim review, NCCI edit checks, fee schedule allowable auditing, and revenue leakage detection for Tennessee practices.
Tennessee Medical Billing Knowledge Hub
Essential regulatory benchmarks, payer policies, and billing guidelines for healthcare practitioners in Tennessee.
Tennessee Medicaid Filing Windows
Claims for Tennessee Medicaid must be submitted within 365 days for TennCare; 90-180 days for MCOs from date of service. Claims exceeding this window are permanently denied unless accompanied by documented proof of timely filing with another primary payer.
Statutory Pay Protection
Under State statutory prompt payment laws (Tenn. Code Ann. § 56-7-109 (21 calendar days)) with strict interest penalty enforcement, commercial insurers and HMOs must settle clean claims on time. Delayed claims trigger statutory interest penalties that our recovery team collects on your behalf.
Tennessee State Provider Portal & MMIS Connectivity
We maintain direct EDI connections for electronic claim submission, real-time eligibility inquiry, and rapid electronic remittance advice posting.
Serving Healthcare Providers Across Tennessee
From major medical districts to community health centers and private practices across the state.
Nashville Metro Healthcare Hub
Key Health Systems: Vanderbilt University Medical Center, HCA Tristar, Ascension Saint Thomas Full-cycle RCM services for specialty practices, surgical centers, and outpatient clinics.
Memphis & Mid-South Region
Key Health Systems: Methodist Le Bonheur, Baptist Memorial, Regional One Health Specialized billing support for independent practices, imaging centers, and regional multi-specialty clinics.
Knoxville & East Tennessee
Key Health Systems: UT Medical Center, Covenant Health, Tennova Healthcare Comprehensive revenue cycle management, credentialing, and denial recovery for community healthcare providers.
Chattanooga & Southeast TN
Key Health Systems: Erlanger Health System, CHI Memorial Hospital Expert billing, coding, and prior authorization workflows tailored to primary care and rural health clinics.
