Skilled Nursing Billing Services in Chattanooga, Tennessee

Chattanooga anchors the southeast corner of Tennessee, where Erlanger and the region's other hospital systems discharge a steady stream of post-acute patients into skilled beds, and where a meaningful share of residents actually live across the line in North Georgia. That border reality complicates eligibility on day one: a resident may carry Tennessee Medicare with a Georgia address, or a dual-eligible whose Medicaid sits in a different state program than the facility expects. On the long-stay side, Tennessee runs its Medicaid long-term care through TennCare CHOICES, a managed long-term services and supports program delivered by BlueCare, Amerigroup, and UnitedHealthcare rather than through traditional fee-for-service. Each of those managed plans sets its own level-of-care determination, patient-liability calculation, and pending-approval rhythm, so a Chattanooga nursing home is really reconciling three payer playbooks at once. Layer growing Medicare Advantage penetration on top of that, and the difference between a facility that collects what it earns and one that writes off good days comes down to whether its billing team actually knows the local plan landscape. A billing company that treats Chattanooga like any other market will leak revenue on the border and on the CHOICES handoffs.

Most write-offs in this market trace to a handful of preventable breakdowns. A late or thin 5-day MDS pushes the stay into the wrong HIPPS group, so the per-diem no longer matches the care delivered. Border eligibility confusion strands claims when a Georgia-resident dual-eligible is billed against the wrong Medicaid program. And the TennCare CHOICES handoff, when a resident drops from a skilled Medicare stay to managed long-term care, is where coinsurance and room-and-board balances quietly age out.

The decision to outsource skilled nursing billing usually comes down to one question: can your in-house office keep every Part A claim tied to a clean, timely MDS while also chasing Medicare Advantage authorizations and three different CHOICES plans? For most Chattanooga facilities the honest answer is no, and that gap is expensive. As a specialized medical billing services company, 247MBS runs the entire institutional revenue cycle — eligibility verification, MDS and PDPM billing support, denial management, credentialing, and A/R recovery — under one accountable team. Our numbers are the kind a facility can plan around: a 99% first-pass clean-claim rate, up to 40% fewer denials, 90% of worked denials recovered, and days in A/R held under 25. A 98% client retention rate reflects two decades of professional, consistent SNF work since 2005. As a billing services company built specifically for institutional long-term care, we are not a general billing company learning PDPM on your dime. Review our statewide reach on the Tennessee billing overview.