Hospice & Home Health Billing in Tennessee

The Billing Pressures Unique to Tennessee

Hospice and home health agencies in Tennessee contend with a specific set of pressures tied to the state’s Medicaid structure:

• Submitting Jurisdiction M Medicare claims correctly and on schedule
• Billing Medicaid-eligible patients through the correct TennCare managed care organization rather than a single state payer
• Reconciling differing authorization and documentation requirements across MCOs
• Keeping internal billing processes current without a dedicated billing team, particularly for smaller agencies

Left unaddressed, these pressures tend to surface as delayed reimbursement, avoidable denials, and administrative strain on internal teams.

Medicare Claims Processed Through Jurisdiction M

Tennessee hospice and home health Medicare claims are processed under Jurisdiction M, administered by Palmetto GBA. Excellence Billing works directly within this jurisdiction, applying current documentation and submission standards so claims move forward without the delays that come from outdated processes or avoidable errors.

Navigating TennCare’s Managed Care Structure

TennCare, Tennessee’s Medicaid program, operates entirely through managed care organizations rather than a traditional fee-for-service model. That structure means every Medicaid-eligible hospice or home health patient is billed through one of the state’s contracted MCOs, each with its own authorization and documentation requirements.

Excellence Billing maintains direct experience coordinating across these MCOs, helping agencies avoid the documentation mismatches that can come from treating TennCare as a single, uniform payer.

Credentialing Through TennCare’s MCO Network

Because every Medicaid claim in Tennessee runs through a managed care organization, credentialing typically requires more coordination than in a fee-for-service Medicaid state. Excellence Billing supports the credentialing process directly, helping new providers and new locations begin billing without unnecessary delay between approval and reimbursement.

Why TennCare’s Model Changes the Billing Equation

Since Tennessee has no traditional fee-for-service Medicaid track for most eligible populations, agencies can’t fall back on a single standard billing process the way they might in a mixed-model state. Every Medicaid claim depends on correctly identifying and billing through the right MCO from the start. Excellence Billing builds its Tennessee billing processes around this reality rather than treating TennCare as an edge case.

Experience Serving Tennessee Providers

Excellence Billing’s work with Tennessee agencies includes managing the dual coordination of Jurisdiction M Medicare claims alongside TennCare’s managed care requirements. Whether your agency is a hospice provider or a home health provider, the team’s experience covers the CAP and cost reporting obligations that apply statewide.

What Working Together Looks Like

Getting started is a straightforward process:

1. Share your agency’s current billing setup, including any TennCare MCO relationships already in place.
2. The team reviews your process and identifies where support is needed most.
3. Excellence Billing transitions applicable billing functions with minimal disruption to daily operations.
4. Your agency receives ongoing, accurate billing management, with the team tracking Jurisdiction M and TennCare changes going forward.