 Practice Analysis
Before we begin billing services for your practice, TMS, Inc. will first perform a practice analysis. We can determine strengths and weaknesses and strategize areas for improvement. |
 Patient Record Setup
TMS, Inc. knows that accurate data entry is the key to getting reimbursed properly and timely. We have checks and balances to ensure that all patient demographics and insurance information is entered exactly as it is submitted to us. |
 Certified Physician Coders
Medical offices lose thousands of dollars due to coding errors. You'll have peace of mind knowing that all of our coders are certified by the American Academy of Professional Coders (AAPC). This exclusive organization certifies over 38,000 coders nationwide and is widely recognized authority on medical coding. In addition we have additional certifications from the American Health Information Management Association (AHIMA) and Registered Health Administrators (RHIA) and Medical Association of Billers. |
 Electronic and Manual Filing
Your medical claims will be prepared and processed to insurance companies. All claims to major insurance companies will be sent electronically or a paper HCFA-1500 Form will be mailed directly to the insurance carrier. If applicable, all claims are filed with a secondary and tertiary carrier. |
Patient Billing
After all insurances have been billed and no payment received, the balance will be transferred to the patient. TMS, Inc. will work diligently to maintain a positive working relationship with your patients. Our billing staff will respond to patient questions regarding details of their insurance coverage and healthcare reimbursement. When appropriate, our billing team will work with your patients to create monthly payment plans. Although these payment plans may represent only a fraction of your receivables, having such a payment plan in place and available will enhance your public image. |
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Compliance Auditing
TMS, Inc. ensures accuracy and guarantees compliance to reimbursement policies in the most efficient and cost-effective manner. We continuously identify areas of improvement and track our performance through audits. The audit process is performed at random and the following is reviewed:
Demographic information, Charge sheet information, CPT and ICD-9 codes, Explanation of benefits for underpayments and overpayment, denials and rejections.
All areas requiring improvement are documented and forwarded to the responsible manager for action. This assessment is necessary to ensure that all Federal and State regulations are adhered to which protect your practice from fraud and abuse.
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 Follow Up
TMS, Inc. aggressively follows up accounts receivable. A good clean claim usually will have a 14-day turnaround. Reports are generated and reviewed to see what claims have not been paid on or denied. We actively pursue all possible avenues for full claim reimbursement to ensure that you receive the highest collection available under law. We regularly generate reports detailing outstanding accounts. If payment has not been received, we begin contacting insurance companies on your behalf.
- After 30 days,
- First claims that were billed once but no payment made are automatically re-billed to primary and secondary insurances
- Second, phone calls are made determine why the claim received no payment or was denied. Depending upon the reason, your billing representative will work closely with the insurance carrier to ensure the claim is re-processed or appealed if we believe you are due payment but denied.
- Third, claims reviewed again to determine payment/denial status and rebilling is done.
Finally, after all payment options have been exhausted, the balance will be transferred to the patient.
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 Insurance Collection Service
Statements are generated for all patients with the physician's permission. This includes all uninsured, cash, deductible, co-pay or payers denied claims. Once an account ages to 120 days past due, we will send a pre-collection correspondence letter to the patient. The letter will have the look and tone of a collection agency without the additional cost of contracting one. Only after final requests for payment are not responded to by the patient, claims will be reported to credit bureaus and judgments will be recorded. |
Claim Posting and Patient Record Updates
Most major insurance carriers post payments electronically. Our billing team will coordinate with your office to receive payment documentation daily so we can track remittance or any follow up needed. |
 Detailed Reports
TMS, Inc. will provide you with useful financial information. We generate standard monthly reports customized especially for your practice. We can provide a financial snapshot of your practice at any given time by running a variety of reports including:
- Batch charge report
- Posting/income report
- Aging report
- Monthly financial report
- Quarterly financial report
- Yearly financial report
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Instant Account Access Available
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. |
