As of October 2026, TSI’s Healthcare Revenue Cycle Management (RCM) service works unpaid and denied insurance claims and early-out patient balances for physician groups and specialty practices. Its Accounts Receivable Management (ARM) service collects patient balances after write-off. Practices on athenahealth, eClinicalWorks, NextGen and other listed systems can send accounts from inside their software.
Got a letter or call from TSI about your own account? Go to the Consumer Support Hub
Where a practice's cash gets stuck
Groups lose money in two places at once. Claims sit in payer follow-up while the team that should chase them answers phones and posts payments.
Then the patient’s share arrives, after the deductible, and nobody has time to call about it. By the time the balance goes to an agency, the patient barely remembers the visit.
"We bill well and still don't get paid"
Denials and underpayments take a specialist’s time, and a small billing office rarely has one per payer.
"The appeal deadline passed while we were short-staffed"
Every payer has its own filing and appeal clock. Missing one turns a fixable denial into a write-off.
"Patients don't open our statements"
Self-pay balances age fast. The longer the gap between the visit and the first call, the harder the conversation gets.
"We won't have a collector treat our patients badly"
Patients come back for follow-ups. A rude agency call costs you the next visit, and maybe a review.
How TSI works your accounts
- Connect to your practice system
TSI exchanges files with your practice management system, or you select and send delinquent patient accounts from inside a listed integration, with no faxing or mailing. - Work claims by payer and denial type
TSI’s claims team follows up unpaid claims and works denials by payer and denial reason, against each payer’s filing and appeal deadlines. - Call patients in your name first
Early-out work uses statements, calls and online reminders in your practice’s name, with payment plans inside your guidelines. Patients pay you directly. - Move to collection only when you say so
Balances you write off can move to third-party collection in TSI’s name, with TSI as your medical collection agency. Credit reporting and legal action happen only when you direct them and the patient’s state allows them. - Keep you in the loop
You track every account’s status online, and when a patient pays the practice, you tell TSI and contact stops.
TSI services that fit physician groups
Denial management
Denied claims worked by payer and reason, with appeals filed on time.
Extended business office
Insurance follow-up and patient balances in your name, as an extension of your billing team.
Early-out self-pay
Patient balances worked in your name before write-off.
Bad debt recovery
Written-off balances collected in TSI’s name, on your rules.
Practice management integrations
Integrations with athenahealth, eClinicalWorks, NextGen, Greenway, MicroMD, gMed, MediTouch and MacPractice. See all technology partners.
Large health systems should see revenue cycle help for hospitals instead.
Rules that shape physician-group collections
Medicare sets a hard clock: claims must be filed within 1 calendar year after the date of service, with narrow exceptions (42 CFR 424.44). Commercial payers set their own deadlines in their contracts, so follow-up has to run against each one.
Uninsured and self-pay patients have a right to a good faith estimate for scheduled care, and can dispute a bill $400 or more above it (45 CFR 149.610). TSI pauses collection on a balance while it’s under dispute.
Medical debt credit reporting keeps changing. A federal court vacated the CFPB’s 2025 medical-information rule on July 11, 2025, and many states limit medical debt reporting on their own, so TSI reports only when you direct it and the state allows it.
TSI doesn’t code charts, credential providers or take over front-desk scheduling. Each engagement is quoted on its own, and TSI hasn’t published denial overturn results for practices, so the Sprint measures them on your claims.
Frequently asked questions
Does TSI work with athenahealth, eClinicalWorks or NextGen?
Yes. TSI’s alliance pages on tsico.com list integrations with athenahealth, eClinicalWorks, NextGen, Greenway, MicroMD, gMed, MediTouch and MacPractice, so practices can send accounts from inside the system.
Can patients keep paying our practice directly?
Yes, during early-out work in your name. Payments go to you, and you tell TSI when a patient pays so contact stops.
What's a good denial rate for a physician group?
It depends on specialty and payer mix.
Will TSI report our patients to credit bureaus?
Only when you direct it in writing and the patient’s state allows it.
Price your denials before you hire for them
The Denials Economics Sprint takes one payer and one denial type, sets a baseline, and reports overturns, paid yield, cost per claim and the claim value below which an appeal loses money. Before you book it, the denial appeal break-even calculator shows the claim value below which an appeal costs more than it returns.
General information, current as of October 27, 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.