Tennessee ranks 25th in population among U.S. states, with 7.2 million residents spanning diverse age groups and ethnicities. This variety creates unique healthcare demands that directly impact the revenue cycle for healthcare providers across the state. MedsIT Nexus is here to support your billing, coding, credentialing, and revenue cycle management needs. As a trusted medical billing partner in Tennessee, we offer tailored billing services and comprehensive practice audits, customizing solutions to meet the state’s diverse demographics and ensure efficient claims processing and optimized revenue.
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Get a QuoteAs of June 2024, Tennessee's Medicaid and CHIP (TennCare) cover approximately 1.4 million individuals, about 20% of the state's population. BlueCross BlueShield of Tennessee is the largest commercial insurer. MedsIT Nexus provides expert Private Practice Billing Services, working with key payers like BlueCross, UnitedHealthcare, Cigna, and Humana. We navigate Tennessee's payer policies and administrative processes, reducing claim denials, streamlining communication, and optimizing revenue cycle management to help providers maintain financial stability and focus on patient care.
Tennessee has over 50 rural health clinics and 80 federally qualified health centers, which are vital for underserved communities. Healthcare providers face challenges with Medicaid reimbursement shortfalls and evolving compliance requirements, particularly in rural areas. At MedsIT Nexus, we specialize in providing tailored billing solutions to help healthcare providers navigate Tennessee’s unique healthcare landscape. With expertise in rural health clinics (RHCs) and federally qualified health centers (FQHCs), we offer accurate coding, compliant submissions, and streamlined claim management, enabling healthcare providers to focus on delivering exceptional care. Our deep understanding of Tennessee’s regulatory environment allows us to optimize revenue cycles, reduce administrative burdens, and ensure financial stability for practices across the state.
The 2024 reports show that Tennessee allocates $47.0 billion to healthcare, ranking 41st in per capita spending nationwide, which creates a strained financial landscape for providers. With limited spending per person, practices are forced to operate under tighter budgets, increasing administrative tasks, and pressure on the revenue cycle. By partnering with MedsIT Nexus, you can improve inefficiencies and enhance your revenue cycle management services. Our advanced revenue cycle billing services help alleviate the administrative load, optimize your financial situation, and reduce the stress of claim rejections.
In Tennessee, medical billing audits can be complex, leading to challenges such as overpayments due to fragmented billing and incorrect claims. These challenges have resulted in over $3.87 million in overpayments and $1 billion in improper, uncompensated care claims. MedsIT Nexus ranks among the top specialists in medical billing audit services, providing comprehensive audits for healthcare facilities across Tennessee. With a deep understanding of local payer regulations and state billing guidelines, we ensure compliance, identify billing inefficiencies, and help our clients maximize revenue.
Volunteer State's medical credentialing process involves lengthy procedures and inconsistent applications, causing delays in patient care and financial setbacks. Smaller practices face limited resources, and the lack of standardization adds to administrative difficulties. Approximately 15.1% of Tennessee's population, over 1 million residents, are enrolled in Medicare, according to 2024 updates. Our medical credentialing services enhance operational efficiency and speed up payer approvals. Using customized software, we verify provider qualifications and ensure compliance with the TDH and insurance guidelines.
Tennessee’s healthcare system is increasingly complex, especially with over 1 million enrollees in TennCare-managed care and Medicare Advantage plans, including 54% in Medicare Advantage. Providers face the challenge of navigating intricate MCO contracts with major insurers like Amerigroup, Blue Cross, and UHC. Additionally, the TennCare Value-Based Care (VBC) model, which includes PCMH incentives of $4 per member per month, adds further complexity to the billing process. In this environment, accurate medical coding and strict compliance are essential to ensure quality-based reimbursements. MedsIT Nexus provides expert Medical Coding services to support healthcare providers, addressing risk adjustment, payer-specific compliance, and precise coding to help maximize revenue while reducing claim denials.
Medical billing management in Tennessee faces significant challenges, with a 30% denial rate for claims due to coding errors, costing $25 per resubmission. With 73% of practices struggling with staffing shortages and a projected 10.5% growth in the $16.8 billion billing market, healthcare providers need efficient systems to manage rising patient financial responsibility and complex regulations. MedsIT Nexus offers specialized Denial Management Services, ensuring precise accuracy, strict compliance, and up-to-date coding practices. Our solutions empower hospitals and healthcare providers to optimize reimbursements while effectively minimizing claim denials.
In Tennessee, 8.3% of residents aged five and older speak a language other than English at home, notably in Nashville, home to the largest Kurdish population in the U.S. By aligning our strategy with Tennessee's demographics and payment systems, MedsIT Nexus streamlines collections, reduces outstanding balances, and improves cash flow for hospitals and specialty healthcare providers. Our Accounts Receivable Management service ensures culturally sensitive and effective follow-up communications, which enhance payment recovery and minimize unpaid balances.
In Tennessee, healthcare providers face challenges with medical insurance verification, particularly among diverse populations. MedsIT Nexus specializes in navigating Tennessee Medicaid, Medicare, commercial insurance plans, and Managed Care Organizations (MCOs), ensuring timely verification of patients' benefits eligibility. Our comprehensive Medical Insurance Verification Services help prevent claim denials and payment delays by identifying copayments, coinsurance, and other financial obligations before care is provided, addressing key economic challenges for providers across the state.
Family Medicine, Internal Medicine, Psychiatry, Emergency Medicine, OB/GYN, Anesthesiology, and Neurology are among Tennessee’s most in-demand specialties, driven by rising healthcare demands. However, with high demand comes complex billing hurdles. Physicians are often burdened by financial roadblocks, including navigating complex Medicaid and Medicare rules, as well as handling specialty-specific coding and denials, especially in rural areas. MedsIT Nexus eliminates the guesswork. Our Physician Billing Services provide specialty-focused support, precise coding, and compliance-driven claim management, allowing you to get paid faster and focus on what matters most: patient care.
As of September 2024, Tennessee's Medicaid program, TennCare, had enrolled approximately 1.44 million individuals, representing about 20% of the state's population. This substantial enrollment underscores the critical role of efficient and compliant billing practices in managing Medicaid claims. In 2022, nearly 60% of Tennessee hospitals operated at a loss, with an average operating margin of -2.9% across the state. Margins decreased by 68% from pre-pandemic levels. These financial challenges highlight the importance of effective hospital billing services in ensuring precise documentation, compliant coding, and audit-ready claims, which support hospitals in both urban and rural areas. MedsIT Nexus offers expert Hospital Billing Services tailored to Tennessee’s complex reimbursement environment. From rural clinics to urban medical centers, we handle inpatient and outpatient claims with precision, ensuring compliant coding, audit-ready documentation, and faster reimbursements to keep your operations financially strong.
Healthcare providers trust MedsIT Nexus
medical billing services company
What sets MedsIT Nexus apart as Tennessee’s go-to billing and coding partner? It’s our unmatched expertise and relentless dedication. We don’t just process claims—we master the intricacies of Tennessee’s billing environment. From decoding complex payer policies to handling nuances in inpatient and outpatient coding, our team ensures that every claim is clean, compliant, and optimized for maximum reimbursement.
Medical billing services start at just 2.69% to maximize savings.
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Reduce costs while ensuring higher reimbursements and profitability.
Recent studies show that as of 2024, over 1.4 million Tennesseans are enrolled in TennCare, 1.48 million in Medicare, and 555,103 in ACA Marketplace plans. This diverse payer mix demands precise billing expertise to ensure compliance and maximize revenue. With over 11 years of experience, MedsIT Nexus excels in navigating Medicare and Medicaid billing, optimizing revenue cycles, and ensuring compliance. Trust our experts to streamline your billing process and drive financial success for your practice.
Call us at +1 (516) 665-1869 for further information.
Doctors lose up to
Billion in U.S
Because of poor billing practices
MedsIT Nexus is a trusted medical billing provider in Tennessee, providing services in every city with precision and care.
Locate MedsIT Nexus medical billing office at your nearest location in Tennessee.
Streamline your revenue cycle with Medsit Nexus by outsourcing your medical billing services in Tennessee. Our expert team ensures accurate coding, timely claim submissions, and compliance with state-specific regulations. Reduce denials, accelerate reimbursements, and focus on patient care while we handle your billing with precision and reliability.
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Dr. Ndidi Uka
A-plus Dentistry
"I want to thank MedsIT Nexus for their impeccable service. They are incredibly knowledgeable and work to make sure you receive the maximum reimbursement. Sam, my dedicated Practice Manager, is always available to answer my questions and keep my abreast on the status of my submitted claims. Being able to bill medical services has allowed me to offer the best care."
M. Techeira
Family Medicine
"We are an outpatient family medicine/ primary care practice. Have offices in NYC and Nassau County. MedsIT Nexus handles all our medical billing and insurance claims. We switched from another company and the process was hassle free, no fees and FAST which was important since we operate 6/7 days. They are always available to answer any questions. We definitely recommend!"
Memoona Waheed
Family Medicine & Pain Management
"After reviewing different medical billing companies, I came across MedsIT Nexus. Not only do they offer billing and coding services, but specialize in credentialing and unpaid claims. Their staff is knowledgeable, professional and are easily accessible- inquiries are answered quickly. Thank you MedsIT Nexus for helping us improve our healthcare practice at a competitive rate!"
S. Dhillon
Physical Medicine & Rehabilitation
"I am the manager at a private physical medicine & rehabilitation practice. We operate in 2 different boroughs in NYC through multiple clinics. MedsIT Nexus handles all our medical billing, coding, denials and prior authorizations for all procedures. We are pleased with their same day approvals as well. Their staff is easily accessible, fast & pleasant to work with."
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Medical Billing Audit
Medical Credentialing
Medical Coding
Denial Management Services
Accounts Receivable Management
Medical Insurance Verification Services
