As of November 2026, TSI collects past-due customer and patient balances for small and mid-size businesses in three steps: Accelerator reminders in your business's name, Profit Recovery demand letters from TSI as a third party, both for a fixed fee per account with payments going to you, then contingency collection for accounts that still don't pay. TSI has collected for U.S. businesses since 1970 and is licensed or registered in every state that requires it.
Results vary by portfolio, including account age, balance and type, and by client program.
- Sent this week18
- Accelerator, your name14
- Profit Recovery3
- Contingency collections1
- Practice systemConnected
- Rule120+ days, $50+
- Payments$4,860
Got a letter or call from TSI about your own account? Go to the Consumer Support Hub or make a payment.
What unpaid balances cost a small business
A small business doesn't have a collections department. It has a front desk, an office manager or the owner, and every hour they spend on past-due accounts is an hour off the work that brings money in.
The accounts also lose value while they wait. The older a balance gets, the less likely it is to be paid, so a stack of 6-month-old invoices is worth less than the same stack at 60 days.
And it's awkward. Nobody wants to call a patient they'll see next month, or a client they'd like to keep, about a balance.
Three ways TSI can help
Accelerator: reminders in your name
Five polite reminders by letter or call over 35 days, sent in your business's name for a low fixed fee per account. Customers pay you directly. It works best on accounts 31 to 60 days past due; membership businesses often start at the first suspended payment.
Profit Recovery: a third party steps in
Five written collection demands from TSI over about two and a half months, rising from a courtesy notice to a final demand. Many balances get paid once a third party is involved. It's a fixed fee per account with no percentage taken, payments still go to you, and it works best at 61 to 120 days past due.
Profit Recovery+: TSI takes the calls and payments
The same demand series as Profit Recovery, except customers who respond are directed to a TSI team instead of your office. TSI's team handles the calls and payments for you, so your staff never have to field them.
Contingency Debt Collection: TSI collects
For accounts that won't pay after reminders, TSI collects in its own name and is paid a share of what it recovers. Credit reporting and legal action happen only if you direct them.
You can use any of them on its own or in sequence. Most businesses start with Accelerator on new past-due accounts, move what's still unpaid to Profit Recovery, and send the rest to contingency collection.
Send accounts from the software you already use
TSI connects to many of the practice management and booking systems small businesses run on, so you can pick past-due accounts and send them to TSI without exporting a file. You set the rules, such as how many days past due and what balance qualifies, and you can stop or suspend an account any time, for example when a customer pays you directly.
Connected systems include athenahealth, Open Dental, eClinicalWorks, NextGen, MediTouch, MicroMD, Practice-Web, Greenway, MacPractice, Planet DDS, gMed, Meevo and Millennium.
Members of AAOMS, the Dental Purchasing Group, HExN and the NRHA get program pricing through their associations.
How it works
Set your rules
Tell us which accounts qualify (days past due and balance), which service each should start in, and how you want to be paid.
Send the accounts
Pick them in your connected software, or upload a file if your system isn't connected.
TSI follows up
Letters and calls go out in the order and under the name your service calls for.
Watch it online
Submit accounts, track status and payments, and train your staff in myTSI, TSI's online client portal, any time. You can stop, suspend or reduce an account when something changes.
Who it's for
Medical and dental practices, physician groups, salons and spas with membership billing, and other businesses whose customers owe them for services already delivered. For larger portfolios, or past-due invoices one business owes another, see Accounts Receivable Management and B2B collections.
General information, current as of November 2026. It isn't legal advice. Rules change and differ by state, so check the sources linked here and talk to your own counsel before you act on it.
The company behind the work
Questions buyers ask
What does a collection agency do for a small business?
It follows up on customer balances you haven't been able to collect: letters, calls and payment options, then, if needed, collection in the agency's own name. TSI can start earlier, with reminders in your business's name.
How much does a collection agency charge a small business?
It depends on the service. Reminder and call programs are often a fixed fee per account, so you know the cost upfront and keep what's paid. Full collection is usually contingency, a share of what's recovered. What collection agencies charge lists published ranges.
When should a small business send an account to collections?
When your own reminders have stopped working and the balance is still worth collecting. Waiting costs you, since older balances are less likely to be paid. Reminders work best at 31 to 60 days past due, and third-party demands at 61 to 120 days.
Will using a collection agency upset my customers?
It depends on how the agency treats them. TSI's reminder services run in your name, in a friendly tone, and customers pay you directly. Accounts only move to collection in TSI's name when you decide.
Does TSI work with my practice management software?
TSI connects to many medical, dental, salon and spa systems, including athenahealth, Open Dental, eClinicalWorks, NextGen, Planet DDS and Meevo. If yours isn't listed, you can send accounts by file.
Is TSI licensed to collect?
TSI is licensed or registered in every state that requires it and authorized to collect in all 50 states, DC and Puerto Rico (NMLS 950422).
Can I stop collection on an account?
Yes. You can stop, suspend or reduce an account online, for example when a customer pays you directly or you settle the balance yourself.
Tell us about your past-due accounts
Roughly how many accounts, how old and what software you use. We'll tell you which service fits and what it would cost.
Got a letter or call from TSI about your own account? Go to the Consumer Support Hub or make a payment.
Let's Connect
Tell us about your accounts
Complete the form below and a TSI specialist will follow up by email.
Paying a bill or have a question about your account? Go to the Consumer Support Hub.