| FAQs
After outlining how beneficial and cost-effective outsourcing your billing can be for your practice, we understand that you may still have lots of questions. So, we have included some of the most frequently asked questions.
How can TMS, Inc. save my practice time and money?
TMS, Inc. knows first-hand that proper patient accounting is one of the most vital functions needed in order for a medical practice to increase cash flow and maintain a healthy bottom line. Here’s how we help your practice become more profitable:
| Savings to Your Medical Practice |
Time |
Money |
Aggravation |
| No money spent on wages, medical benefits for a billing staff |
X |
X |
X |
| No vacation or personal time or sick days to schedule around |
X |
X |
X |
| No hassles and headaches associated with patient billing and inquiries |
X |
X |
X |
| No cost to the practice for computer software/equipment, educational training, accreditation or seminars |
X |
X |
X |
| More time for patient care! |
X |
X |
X |
| More office space transformed into revenue generating areas such as more exam rooms, etc. |
X |
X |
X |
| Access to physicians, medical billers, coders, business managers for consultation about improving your practice |
X |
X |
X |
| Reducing turnaround time of getting insurance companies to pay on claims |
X |
X |
X |
| Reviewing all claims to ensure accuracy of billing information before submission and review of each claim to ensure proper payment has been made |
X |
X |
X |
| Detecting and addressing inaccurate codes that would normally receive rejection from insurance companies |
X |
X |
X |
| Understanding new changes and collection protocol for Workers Comp Medicare and Medicaid patients |
X |
X |
X |
| Recognizing and explaining medical billing tests that frequently raise red flags to insurance companies requiring them to withhold payment, or to hold the invoice for further investigation |
X |
X |
X |
| Significant follow up on outstanding accounts |
X |
X |
X |
How do I know if my practice will benefit by contracting TMS, Inc. for medical billing services?
We offer a free initial consultation with our physicians and key members of our medical billing staff to determine your billing department's strengths and weakness. We offer viable solutions to remedy areas needing improvement.
How do I know that you will be more effective than our own office staff?
We are efficient, timely and accurate (we do not send out claims that we are not completely confident will be paid). We have a highly dedicated staff that collectively brings to the company many years of healthcare and billing experience. Because we take a team approach, we are not impacted when one individual has to leave for vacation, illness or training.
My office records all of our records manually. My office keeps all records electronically. Can you work with our records?
Certainly! Whether you store medical records electronically or manually we can serve you.
How quickly can you get our office up and running?
We will work to create the smoothest transition possible as timely as possible. (This is also dependent upon credentialing if you are a new practice which may take longer). We also like to start at the beginning of the month so that it is easier for you to separate your previous dates of service from the “cutover” dates to TMS, Inc.
Should we continue to work our previous billings/collections once you take over?
If possible, we prefer that you continue to work (post payments and re-bill) your existing accounts receivable for a period of three months. If this is not possible, we can handle that as well.
Will I have a person dedicated to our account?
Yes. A designated billing representative will be assigned to your account. Your billing rep will know the intricate details of your account.
How do we get our existing patient data to you?
There are 2 options: 1.) A complete printout (or softcopy) from your existing system. 2.) Provide to us the most current patient information as you see them. This also gives you the opportunity to "start fresh" with your data and have your patients re-register.
How do I know that my information will be kept confidential?
Our employees sign a confidentiality agreement. Only designated billing staff will have access to your data, including your explanation of benefits (EOBs) and monthly statements. In addition, we adhere to all HIPAA policies and have a comprehensive compliance program in place.
How do we get our claims to you? How often?
You can fax, mail (priority) or deliver claims via courier service as frequently as you feel necessary: daily, once a week or three times per week.
How often are my claims processed?
Within 24-48 hours of receipt.
How quickly do we get reimbursed?
The variance of payers and many outside factors make this a difficult question. However, the average turnaround in the industry is 30-45 days. Obviously, some are more and some are less. The fact is that Medicare/HCFA is required to hold the claim for 13 days for all electronic claims and 23 days for paper submissions. Even for commercial payers, 14 days is an exception and certainly not the rule. The National average for Days In AR (for Family Practice) is 43.
Will you also re-submit for secondary insurance, tertiary?
Both Secondary and Tertiary resubmissions are included in our service.
Where or to whom are all the insurance reimbursement payments sent to?
All payments are sent directly to your office or a financial institution designated by you. You then send us a copy of the insurance payment check, the Explanation of Benefits (EOB), and copies checks that are from co-pays taken at your front desk as well as copies of electronic insurance payments made to your account. All of this information is needed so we can appropriately track all reimbursement activity.
Do I have access to my account information?
We completely understand how important it is for you to be able to view your account data and follow along with the billing process any time you wish, because after all this is YOUR money at stake! You can monitor the progress we are making any time you wish—so you always know what's going on.
Do you transmit claims electronically?
Yes, to those companies that have the capabilities and that are efficient with EMC (Electronic Medical Claims). We do process certain payers on paper only because it has been our experience that those are actually paid faster. Remember, most insurance companies require that you are credentialed with them before we are able to submit electronically on your behalf.
What is your average collection rate?
We are very competitive in collection abilities and are confident that we can increase your collection rate.
What type of software do you use?
We use MicroMD.
Why do some billing firms only charge by the claim vs. a percentage of collected revenue?
Most billing firms will charge you a percentage of what they collect. They are more compelled to work harder, follow through with secondary submissions, denials and work to get you the highest reimbursement possible – a "win-win" for both.
Are you HIPAA compliant?
Yes! We have a full time compliance manager that keeps our company compliant.
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