For medical practices
Sometimes the problem is not the patient. It is the payer.
Practices tend to treat aging receivables as one pile. They are two piles, and confusing them is expensive. Money a patient owes you is a collections problem. Money an insurer owes you is a claims problem, and no collection program in the world will fix it.
If a meaningful share of what is sitting on your aging report is unpaid or denied claims, you need denial and appeals work, not receivables recovery.
Why denied claims quietly become write-offs
A denial is not a no. It is a delay with a deadline attached. Appeals take time, they take documentation, and they take somebody who knows the payer's specific rules. Most practices do not have that person, or have one person who is already underwater. So denials get reworked when there is time, which there never is, and eventually they age past the appeal window and turn into write-offs nobody decided to take.
That is the loss worth attacking, because unlike patient balances, this money was already earned and already approved as covered work.
What the service does
The program is delivered through Transworld Systems, and the description here is theirs. It handles claims and denials optimization with the stated goal of accelerating reimbursement and reducing aging inventory. TSI describes automated decisioning and workflow automation under the name PULSE AI, applied to routing and resolving claims.
Delivery is configurable. It can sit on top of your existing billing staff and absorb overflow, or it can take the function entirely. Most practices should start with overflow, because it is reversible and you find out quickly whether it is working.
I have not audited TSI's technology claims and you should not take them from me. If this becomes a serious conversation, ask them directly for performance data on practices your size and in your specialty.
How to know which problem you have
Pull your aging report and split it by responsible party. If most of what is past ninety days is patient responsibility, you want the receivables programs. If most of it is insurance responsibility, you want this. Plenty of practices need both, and they are separate engagements.
If you are not sure how to split it, that is a fine reason to call. It is a fifteen minute conversation and it determines everything that follows.
Common questions
How is this different from a collection agency?
Completely different. Collections pursues money a person owes you. Denial management pursues money an insurer owes you, by correcting, resubmitting, and appealing claims. Different work, different skills, different vendor teams.
Do I have to replace my billing staff?
No. The most common setup is overflow support, where your team keeps the function and the service absorbs what they cannot get to. Full outsourcing is available but it is rarely where I would start.
Is this HIPAA compliant?
TSI states that it maintains controls for protecting patient information and that it is a certified SSAE 16 SOC 1 Type 2 service provider. Those are their representations. Ask for their current documentation as part of your normal vendor review rather than relying on a claim on my website.
Start with a conversation, not a contract
Tell me what you are dealing with and I will tell you plainly whether I can help. If the answer is no, you will hear that too. There is nothing to sign and nothing to prepare beforehand.