Your Team of Revenue Cycle Experts
TSI Healthcare RCM’s niche services and expertise in healthcare reimbursement, combined with innovative technology and a proven track record of success, make us a strong partner for hospitals and physicians. We work with healthcare providers looking to optimize their revenue cycle operations and maintain the overall health of their accounts receivable. Our offerings range from pre-service to patient payment, with the expertise to secure reimbursement from both third-party payors and patients. With over 50 years of experience in the market, our team has a proven track record of liquidating receivables at a higher rate than internal teams and competitors.
We leverage a blend of clinical and legal expertise, combined with innovative technology to help increase cash flow for hospital and physician partners while driving down aging. We have the knowledge and tools necessary to navigate the complex and constantly changing landscape of healthcare reimbursement. Our team can provide an analysis of your current RCM processes and help you create a strategy tailored to your organization. We leverage advanced technology, analytics, and workflow automation to help you reduce A/R days, optimize revenue, increase patient satisfaction, and reduce time-to-payment.
Our comprehensive RCM services are designed to deliver maximum revenue and process efficiencies, while providing a superior patient experience. TSI’s team provides additional proficiency, oversight, and security to ensure that receivables are managed effectively. By partnering with TSI, hospitals can focus on providing quality care to patients while leaving the revenue cycle management to TSI.
TSI Healthcare recovers over $2 billion for our clients annually, and is a leading provider of Customer Account Support, Customer Claims Denial Support, Aged Problem Claims, and Third-Party Claims, such as Workers’ Compensation, Motor Vehicle Accident, Veterans Administration and Government healthcare claims support.
Hospitals, Physicians, and ASCs
Customer Service
TSI recognizes that patient satisfaction and performance are critical components of successful outsourcing partnerships. Maintaining a positive reputation and protecting our clients’ brand is an essential aspect of our business relationships. By prioritizing patient satisfaction, TSI helps our clients increase customer loyalty.
The experience during the first point of contact (the first impression is the lasting impression) sets the stage for a successful resolution strategy. We offer solutions that simplify what can be a daunting experience for patients and clients alike. Focused on one call resolution, our goal is to have every interaction be a great customer experience.
- Customer Experience Programs
- Flexible staffing solutions
- Application Assistance
- Payment Plan Servicing
- Account Management
- Back Office Solutions
Debt Validation
TSI’s Debt Validation Services empower businesses to achieve responsible and compliant debt collection by prioritizing compliance, accuracy, and transparency.
Our services are designed to help businesses maintain consumer trust, reduce administrative burdens, and minimize risks associated with debt collection. By verifying and substantiating the legitimacy of debts before any collection actions, we ensure that every step in the process meets regulatory standards, fostering consumer confidence and avoiding costly errors.
Working with TSI, you benefit from thorough documentation verification, regulatory compliance checks, and confirmation that services billed were provided. Our advanced technology streamlines the entire validation process with automated verification and seamless data integration, enabling efficient and accurate debt management.
Early Out Self-Pay
Understanding how critical it is to elevate the level of patient satisfaction, being sensitive to our client’s reputation in the community and protecting their brand, we encourage a culture of partnership and transparency.
Our Patient Experience Philosophy is the cornerstone of our Self-Pay environment, offering patients flexible, customizable solutions, backed by a patient friendly approach. We deliver a state-of-the-art patient service solution that leverages our industry-related telephony capabilities and verifiable on-shore, dedicated team of experienced patient advocates.
TSI’s Early Out Self-Pay program combines the latest predictive dialing technology, advanced healthcare scoring models, remote observation capabilities, providing a cost-effective solution for managing self-pay receivables.
Our omni-channel solutions, include customized IVR, advanced online bill payment capabilities, educational and patient-friendly statements, evolving payment arrangement protocols and terms.
Third Party Receivables Management
Recovering healthcare patient balance delinquencies has been TSI’s focus from the very beginning – that’s over 50 years of specialization. We understand the unique nuances of each program and tailor our treatment strategies accordingly.
Achieved through innovative analytics, powerful workflow technology, portfolio analysis and scoring, and dynamic client contact strategies with omni-channel communications, we provide an exceptional client experience with best-in-class resolution rates.
Our teams leverage specialized debt training, tools, and processes while adhering to federal, state, and local regulations in order to protect their client’s brand. TSI’s experienced leadership team and program management prioritize a compassionate approach to collections while maximizing recoveries and positively impacting our client’s reputation.
Third Party Insurance
– Accounts Receivable Management
TSI employs a dedicated team of revenue cycle experts who specialize in navigating the Payor nuances to increase reimbursement rates for our clients.
We are laser focused on providing comprehensive and specialized healthcare billing and claims management services. Our use of revenue cycle experts, and advanced technology demonstrates that we recognize the specialty skill sets needed in navigating the complexities of healthcare billing and claims management.
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Clinical Denials
Insurance denials and underpayments are a significant concern for healthcare financial executives, representing a substantial percentage of all claims submitted.
By combining our unique blend of clinical and legal expertise with our advance technology, we are able to provide a more effective and efficient approach to managing clinical denials and underpayments and drive higher liquidations in a reduce period of time.
Moreover, written appeals can be an effective strategy for securing reimbursement on denied accounts. By leveraging the expertise of the team, TSI can craft compelling appeals that present a strong case for reimbursement, increasing the chances of a successful outcome.
- Clinical Denials
- Medical Necessity
- Experimental Drugs & Procedures
- DRG Downgrades
Specialized Programs
By conducting a thorough review of accounts that are not being effectively pursued, TSI’s team of experts aims to identify any additional reimbursements that may be due. This can help healthcare organizations optimize their revenue and improve their financial performance.
Utilizing healthcare specialists to provide intensive follow-up on delayed accounts demonstrates a commitment to resolving outstanding issues and ensuring timely payment. These specialists are trained to navigate the complexities of healthcare billing and reimbursement processes, allowing them to address any obstacles that may be preventing prompt payment.
- Clinical & Technical Denials
- Payor Specific Claims
- Legal Escalation Team
- Payor Reconditioning
- Onshore & Offshore Resources
Workers’ Compensation Claims
TSI deploys a dedicated team that understand each state’s rules and laws related to Workers’ Compensation claims. We also provide a nationwide fee schedule calculator and a team of specialists focused on recovering underpaid claims. They are focused on achieving the highest levels of reimbursement by using specialized technology, and specialized knowledge of state specific statutes and regulations.
Our rigorous approach to follow up on claims ensures that all accounts are managed by specialists who know how to quickly get the attention of payers and secure accurate and timely payments.
Motor Vehicle Accident &
Third-Party Liability Claims
Our approach begins with managing motor vehicle accident accounts immediately following from the patient’s discharge, evaluating all potential payers and pursuing all payment sources, including the patient’s insurance policies, the responsible party’s automobile insurance policy, and alternative sources such as the patient’s health insurance carrier, Medicare, or Medicaid.
When warranted, we protect the interests of our clients through the timely filing of liens and procurement of enforceable letters of protection from the patient’s attorneys.
Our specialized team has the legal expertise and understands the state and/or county specific regulations required to resolve these complex claims.
Veterans Administration Claims & Government Claims
Given the navigation issues surrounding VA claims, having a team of experts who understand these intricacies is a critical asset for those providers caring for our veterans. By leveraging this expertise, we navigate the VA claims process more efficiently and effectively, resulting in earlier, and increased reimbursements.
TSI’s approach is focused on maximizing revenue recovery and minimizing revenue loss for healthcare organizations.
Coordination of Benefit Claims
Our team understands the challenges healthcare providers face when presented with coordination of benefit issues. Patients may not always be fully engaged on this topic. A miscommunication in coordination of benefits can inhibit insurance companies from paying on claims. In fact, the way an insurance company interprets the coordination of benefits may vary, and the patient is ultimately responsible for knowing their benefits; however, if you resort to sending these accounts to self-pay, it could potentially harm the patient experience.
At TSI Healthcare RCM, we have a diverse team with unique strengths, knowledge and credentials. We hire individuals who have worked both on the provider and payer side of the business, giving us a unique insight as to how the model works. Coordination of benefits relies on many sources of information including federal and state programs. The TSI Healthcare team is familiar with all scenarios that involve multiple payers, to include commercial, government and liability cases.
TSI Healthcare also utilizes and deploys technology that helps identify both whether there may be a coordination of benefits issue on a particular claim, as well as the likely order of responsibility.
Coordination of benefits and associated issues are among the top five denial reasons experienced by hospitals and physician groups. Knowing how to work, manage and ultimately resolve them will have a significant impact on a provider’s overall AR.
Conversion Run Down Program
We deploy a highly specialized team to assist clients with seamless transitions to their new patient accounting system.
Our breadth of system conversion experience and specialized resources enables our client’s revenue cycle team to learn a new system, without distraction or degradation in the AR management process.
We customize project plans to assist with a wide variety of AR conversion needs, including working specific payers and/or age categories.
Our expertise includes extensive experience with almost every patient accounting system, including but not limited to: EPIC, Cerner, Sorian, Meditech, HealthQuest, Allscripts, etc.
Small Balance Insurance
We recognize that these claims, although individually smaller in value, can collectively have a significant impact on revenue when left underworked. By allocating resources primarily to higher-value account balances, healthcare organizations may inadvertently miss opportunities for reimbursement, negatively affecting cash flow.
To tackle this challenge, we have implemented customized systems and processes specifically tailored to handle high volumes of low balance claims. These systems involve automation and technology solutions that streamline the workflow, allowing for efficient management of numerous claims simultaneously.
This approach ensures that even smaller accounts receive proper attention and follow-up, ultimately leading to increased revenue recovery.
Back Office Support
Efficiency is the engine behind great results. Fueled by secure, energy-efficient, redundant operating centers around the globe and fault-tolerant technology, we customize solutions that drive better business outcomes and empower financial success.
Utilizing business analytics and modeling, RPA, AI and robust QA, we provide a range of administrative and operational tasks that are necessary for running a business or organization but do not involve direct patient-facing interactions.
The benefits of outsourcing your back-office support services to TSI include cost savings, increased efficiency, access to specialized expertise, technology, and the ability to scale up or down as needed.
- Account Reconciliations
- Data processing
- Data entry
- Document Processing
- Validation and verification processing
Medical Insurance Companies
Customer Service
TSI recognizes that client satisfaction and performance are critical components of successful outsourcing partnerships. Maintaining a positive reputation and protecting our clients’ brand is essential aspects of our business relationships. By prioritizing client satisfaction, TSI helps our clients increase customer loyalty.
The experience during the first point of contract (the first impressing is the lasting impression) sets the stage for a successful resolution strategy. We offer solutions that simplify what can be a daunting experience for clients and customers alike. Focused on one call resolution, our goal is to have every interaction be a great customer experience.
- Customer Experience Programs
- Flexible staffing solutions
- Application Assistance
- Account Management
- Back Office Solutions
Back Office Support
The difference between good and great operations comes down to one thing: efficiency. That’s why our business process outsourcing operation is such an advantage to our clients. Fueled by secure, energy-efficient, redundant operating centers around the globe and fault-tolerant technology, we customize solutions that drive better business outcomes and empower financial success.
TSI provides a range of administrative and operational tasks that are necessary for running a business or organization but do not involve direct customer-facing interactions.
The benefits of outsourcing your back-office support services to TSI include cost savings, increased efficiency, access to specialized expertise, technology, and the ability to scale up or down as needed. Additionally, outsourcing these functions can free up valuable time and resources for your business to focus on growth and innovation.
- Account Reconciliations
- Data processing
- Data entry
- Document Processing
- Validation and verification processing
State and Federal Agencies
Customer Service
TSI recognizes that member satisfaction and performance are key components of successful outsourcing partnerships. Maintaining a positive reputation and protecting our clients’ brands are critical aspects of our business relationships. By prioritizing member satisfaction, TSI helps our clients build loyal and satisfied members, leading to long-term growth and success.
The first point of contact with the member is critical to both their experience and impression of your organization’s brand. At TSI, we offer customer service solutions that simplify what can be a daunting experience for State/Federal agencies and their members alike. We help members with inquiries, and enrollment needs, with the goal of one call resolution and increase customer satisfaction. By streamlining the member’s experience, we can help improve revenue retention and enhance the reputation of our clients.
- Enrollment Services
- Member Services
- Customer Service Calls
- Outbound Call Services
- Annual Notices of Change
- Technical Support Calls
Back Office Support
Efficiency is the engine behind great results. Fueled by secure, energy-efficient, redundant operating centers around the globe and fault-tolerant technology, we customize solutions that drive better business outcomes and empower financial success.
Utilizing business analytics and modeling, RPA, AI and robust QA, we provide a range of administrative and operational tasks that are necessary for running a business or organization but do not involve direct customer-facing interactions.
The benefits of outsourcing your back-office support services to TSI include cost savings, increased efficiency, access to specialized expertise, technology, and the ability to scale up or down as needed.
- Account Reconciliations
- Data processing
- Data entry
- Document Processing
- Validation and verification processing
- Exception Processing
