What dispute deadlines should providers track in Tennessee?

Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Insurer 60-Day Demand Window: 60 calendar days from formal written demand before 25% bad-faith penalty attaches (Tenn. Code Ann. § 56-7-105). Verify the trigger date, current agency notices, and any extension before acting.

Which agencies administer these rules in Tennessee?

The guide identifies Tennessee Department of Commerce and Insurance (TDCI). The correct agency depends on the plan and claim jurisdiction.

Auto Accident, PIP & Medical Billing State Guides

Tennessee Auto Accident, PIP & Medical Billing Laws

Tennessee operates an At-Fault automobile insurance framework under Title 55 and Title 56 of the Tennessee Code Annotated (T.C.A.). The state enforces a strict 1-year statute of limitations for personal injury. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory hospital liens under Tenn. Code Ann. § 29-22-101, which are capped at one-third of the patient's tort recovery.

Accountability & Review

Reviewed by Millennova Legal Operational Integrity Team, Senior Audit and Arbitration Analysts

Last Reviewed

2026-03-01

Plain-language overview

At-Fault / Traditional Tort (1-Year Statute of Limitations & Tennessee Hospital Lien Act)

Tennessee is a modified comparative fault jurisdiction (49% rule, McIntyre v. Balentine). Auto liability insurance is mandatory, while first-party Medical Payments (MedPay) coverage is optional. Personal injury tort claims are subject to one of the shortest statutes of limitations in the United States: exactly one year from the date of the collision under Tenn. Code Ann. § 28-3-104. Healthcare providers treating accident victims utilize MedPay assignments and enforce statutory hospital liens against third-party liability proceeds under Tenn. Code Ann. § 29-22-101.

PIP and MedPay coverage

Optional Med Pay Coverage

MedPay is optional in Tennessee (typically written in limits of $1,000 to $10,000+), covering reasonable medical, surgical, dental, ambulance, and funeral expenses incurred as a result of an automobile collision

Made Whole Doctrine

Under Tennessee common law (York v. Sevier County Ambulance Authority), an insurer's contractual subrogation right for MedPay benefits is subordinate to the injured insured's right to be made whole for all economic and non-economic damages

Assignment Of Benefits

Healthcare providers routinely accept patient assignments of MedPay benefits to bill auto insurers directly

Medical fee schedule and reimbursement rules

Name

Reasonable and Customary Fee Standard

Rules

Tennessee does not enforce a statutory fee schedule table for motor vehicle accident medical bills. Providers bill based on reasonable and customary charges prevailing in the local healthcare community for comparable care.

Cpt Basis

CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims

Preauthorization and utilization review

Requirement

Preauthorization is not required by statute for emergency medical stabilization or acute outpatient diagnostics. Elective procedures, specialized pain management injections, and extended physical therapy plans are evaluated under insurer medical necessity guidelines.

Independent Medical Review

Insurers may request medical records or independent physician reviews to evaluate causal relationship to the motor vehicle crash.

Appeals and dispute resolution

Statutory Bad Faith Penalty

Under Tenn. Code Ann. § 56-7-105, if an insurer fails to pay a covered loss within 60 days after demand, and the refusal is not in good faith, the court or jury may award an additional bad-faith penalty of up to 25% of the loss plus liability.

Hospital Lien Act

Under the Tennessee Hospital Lien Act (Tenn. Code Ann. § 29-22-101 et seq.), any hospital in Tennessee has a statutory lien upon all claims and judgments of an injured person for reasonable hospital charges. The lien must be recorded in the circuit court clerk's office within 120 days of discharge. Under § 29-22-101(b), the hospital lien cannot exceed one-third (33.3%) of the patient's gross settlement or judgment.

Dispute Forum

Tennessee Circuit Court or General Sessions Court (for claims within general sessions monetary jurisdiction) for civil recovery actions.

Claim and dispute deadlines

Deadlines can depend on the trigger event and may be affected by agency relief notices. Confirm the live rule before filing.

Event	Timeframe
Accident Notice	Notice to insurer as soon as reasonably practicable
MedPay Claim Submission	Submission within standard policy billing deadlines (typically 1 to 3 years)
Insurer 60-Day Demand Window	60 calendar days from formal written demand before 25% bad-faith penalty attaches (Tenn. Code Ann. § 56-7-105)
Hospital Lien Perfection	Must be filed with circuit court clerk within 120 days of patient discharge (Tenn. Code Ann. § 29-22-102)
Statute of Limitations	1 year from accident date for personal injury tort claims (Tenn. Code Ann. § 28-3-104); 6 years for contract claims

Documentation checklist

Tennessee MedPay Claim Application Form
Executed Assignment of Benefits (AOB) and medical records authorization
Itemized CMS-1500 or UB-04 billing statement with CPT/HCPCS codes and ICD-10 diagnostic coding
Contemporaneous medical records, emergency intake documentation, operative reports, and imaging findings
Filed Notice of Hospital Lien with circuit court clerk recording stamp (for hospital claims under Tenn. Code Ann. § 29-22-102)
Insurer Explanation of Benefits (EOB) or written explanation of claim determination

Responsible agencies

Tennessee Department of Commerce and Insurance (TDCI)Statewide Regulation of Auto Insurers, Market Conduct & Consumer Inquiries

Primary legal and regulatory sources

Tennessee Code Annotated Title 29, Chapter 22 (Hospital Liens)Tennessee General Assembly · 2024
Tennessee Code Annotated Title 28, Chapter 3, Section 28-3-104 (Personal Tort Actions; One-Year Limitation)Tennessee General Assembly · 2024

This operational reference is educational, is not legal advice, and does not create an attorney-client relationship.

Common questions

What rules govern auto accident, pip & medical billing state guides in Tennessee?: Tennessee operates an At-Fault automobile insurance framework under Title 55 and Title 56 of the Tennessee Code Annotated (T.C.A.). The state enforces a strict 1-year statute of limitations for personal injury. Medical providers utilize optional first-party Medical Payments (MedPay) and enforce statutory hospital liens under Tenn. Code Ann. § 29-22-101, which are capped at one-third of the patient's tort recovery.
What dispute deadlines should providers track in Tennessee?: Accident Notice: Notice to insurer as soon as reasonably practicable; MedPay Claim Submission: Submission within standard policy billing deadlines (typically 1 to 3 years); Insurer 60-Day Demand Window: 60 calendar days from formal written demand before 25% bad-faith penalty attaches (Tenn. Code Ann. § 56-7-105). Verify the trigger date, current agency notices, and any extension before acting.
Which agencies administer these rules in Tennessee?: The guide identifies Tennessee Department of Commerce and Insurance (TDCI). The correct agency depends on the plan and claim jurisdiction.