Medical Billing Services in Tennessee: Data-Driven RCM for Local Providers
Maximize Your Practice Revenue with Tennessee’s Specialized Billing & Healthcare IT Partner
Acuity Health Solutions provides end-to-end medical billing and Revenue Cycle Management (rcm) solutions operating in Tennessee and is designed with healthcare providers in mind. Practices in a state where payer rules, Medicare mandates, and Medicaid procedures are constantly being revised need not only billers but also strategic partners who are knowledgeable about the local ecosystem, regulatory environment, and the subtleties of healthcare payers in Tennessee.
We provide custom solutions that enhance cash flow, reduce denials, and maximize revenue capture for busy metropolitan centers such as Nashville, Memphis, Knoxville, and Chattanooga, as well as independent and rural clinics across the Volunteer State.
Medical billing is much more than making claims; it is managing the workflows between receiving patients and posting payment, including coding, checking eligibility, avoiding denials, handling appeals, and reporting. The RCM model developed by Acuity assists Tennessee providers in making their operations more efficient and less administrative, with the end result that clinicians are likely to focus on patient care rather than paperwork and reimbursement challenges.
Our Tennessee Connection: Bridging Business Growth and Local Care
Acuity Health Solutions focuses on Tennessee healthcare providers and employs a strategic, localized RCM approach. We understand that practices in Davidson County face a more complex payer landscape than those in East Tennessee or West Tennessee. To provide accurate billing, it is necessary to understand not only national payer rules but also state-specific policies and payer edits that may directly impact reimbursements and compliance.
In contrast to generic billing companies that use a general workflow, Acuity is tightly integrated with Tennessee payer needs, such as local coverage determinations (LCDs), immediate pay requirements, and state-specific payer edits, which affect claim acceptance. We optimize your revenue performance to help you achieve your clinical and financial objectives by developing RCM workflows tailored to your locality and specialty.
Mastering the Tennessee Payer Landscape
Comprehensive Payer Expertise Across Tennessee
Navigating the Tennessee payer ecosystem requires more than surface-level familiarity. Each payer, including commercial, Medicaid, Medicare, and Medicare Advantage, operates with distinct policies, authorization workflows, reimbursement rules, and audit expectations that change frequently.
Acuity Health brings deep, payer-specific expertise across the entire Tennessee landscape, enabling providers to reduce denials, accelerate reimbursements, and stay compliant as payer policies evolve.
TennCare (Medicaid) & Managed Care Organizations (MCOs)
Tennessee’s Medicaid program, TennCare, operates through multiple Managed Care Organizations (MCOs), each with its own claims logic, eligibility rules, and reporting requirements. Our team has hands-on experience managing claims and compliance across all major TennCare plans, including:
- UnitedHealthcare Community Plan of Tennessee
- BlueCare
- WellPoint
Our TennCare expertise includes provider enrollment and revalidation, eligibility verification, encounter and claim submission, value-based incentive reporting, and proactive follow-ups to prevent payment delays. We ensure strict adherence to TennCare guidelines while optimizing reimbursement within program rules.
BlueCross BlueShield of Tennessee (BCBST)
As the dominant commercial payer in the state, BlueCross BlueShield of Tennessee requires precise compliance with evolving medical policies, particularly for outpatient procedures, imaging, surgical services, and prior authorization workflows.
Acuity Health maintains continuous alignment with BCBST policy updates to:
- Prevent avoidable denials due to authorization or documentation gaps
- Reduce retro-denials and extended AR cycles
- Ensure reimbursements align with current fee schedules and medical necessity criteria
Our payer-aligned RCM workflows are designed to eliminate revenue leakage caused by missed authorizations or outdated policy interpretations.
Commercial & Medicare Advantage Plans
Tennessee providers often manage a complex mix of commercial and Medicare Advantage plans, each with unique coding, documentation, and payment rules. Acuity Health supports all major national and regional payers, including:
- Cigna
- Humana
- Aetna
- Regional and national Medicare Advantage plans
Our certified coding and billing teams apply payer-specific rules at the front end, during charge capture and coding, to minimize downstream denials, audits, and payment delays. This proactive approach significantly improves first-pass acceptance rates and overall cash flow.
One Partner. All Tennessee Payers Covered.
Acuity Health’s payer expertise is not generic; it is payer-by-payer, policy-by-policy, and state-specific. By covering all major Tennessee payers under one RCM framework, we reduce administrative burden for providers while improving financial performance.
This broad payer coverage allows Tennessee practices to focus on patient care while we manage the complexity behind the scenes, confidently, compliantly, and efficiently.
Serving Every Corner of the Volunteer State
Acuity Health Solutions offers highly customized, end-to-end RCM solutions across the entire state of Tennessee and beyond:
Nashville and Middle Tennessee – To large volume specialty groups and multi-provider clinics that are negotiating heavy payer contracts.
Memphis and West Tennessee- Caring for complicated Medicaid populations and hospital-based practices.
Chattanooga, Knoxville, & East Tennessee- Practices in rural areas and regions use centralized denial management and payer reconciliation workflows.
Secondary Markets- Clarksville, Murfreesboro, Jackson, and other community-based practices with customized support in RCM. We offer scalable services to private practices, large multispecialty groups, ambulatory surgery centers, and allied health facilities.
Regulatory Excellence: Tennessee Prompt Pay & Workers’ Comp
The Tennessee law includes statutes intended to safeguard the providers’ financial interests when they are leveraged properly. The team at Acuity is implementing these laws in the performance strategy of RCM.
Tennessee Prompt Pay Act Enforcement
By T.C.A. 56-7-109, the payers must accept clean electronic claims
within a period of 21 days. In cases of underpayment, our team is vigorous in pursuing the 1 percent monthly interest on late payments, which has made regulatory compliance a plus for your practice.
Workers’ Compensation Medical Fee Schedule
The workers’ compensation fee schedules in Tennessee do not follow the regular payer regulations. With accurate billing, our billing professionals are dedicated to ensuring that all orthopedic, surgical, and therapy claims are billed at the maximum possible rates and under the 2026 schedule, so our revenue is not compromised. These regulatory tips give practices added security that claims are presented correctly, but they are also pursued as far as possible in cases where payers are procrastinating or underpaying.
Specialty-Specific RCM Excellence
Although we cover a wide set of specialties, our deep dive capabilities cover areas of key high impact:
Ophthalmology and Oculoplastic Billing– In-depth understanding of the vision plan billing, payer edits, and complicated documentation.
Infusion Therapy- High-cost drug authorization and payer compliance of injectable and biologic therapies.
Surgical Centers (ASC) – Bundle optimization, division of professional fees, facility fees, and payer-specific reimbursement regulations.
Multi-Specialty Clinics- Workflow tailored to a variety of service lines to ensure claims accuracy and timeliness.
In every specialty, Acuity uses rigorous methods to improve understanding of payer rules, reduce denials, and position reimbursements.
Why Acuity is the Leader in Tennessee Medical Billing
Acuity stands out due to quantifiable deliverables and open processes:
98% First-Pass Clean Claim Rate – Payers It operates on the basis of payer-aligned coding, eligibility checks, and compliance checks.
Real-Time Transparency- Does it have access to detailed dashboards displaying revenue performance, denials, and payer trends?
Credentialing and Enrollment Expertise –Effective enrollment using TennCare, Medicare, and commercial payers to start billing sooner.
Denial Prevention & Appeal Services- Entire teams of people that detect patterns, solve root causes, and recover lost revenue. By outsourcing your billing to Acuity, you can save on overhead costs, in-house management is no longer necessary, and financial predictability is enhanced.
Get Your Free Tennessee Practice Revenue Audit
Unspoken negative responses, insurer inaccuracies, and wasteful processes may be reducing revenues without your intention. Acuity Health Solutions offers a free, full-service RCM audit that identifies revenue leaks, streamlines processes, and reveals the possibility of a quick fix.
Our audit assesses your claim cycle, including intake, payment, and systemic issues, and offers recommendations to take action that precondition increased collections, reduced denials, and financial optimization.
