Best Medical Billing Services in the USA
Medical Billing Servcices For USA Healthcare
At TMS Billings, we deliver expert medical billing and revenue cycle management (RCM) services in the United States, helping healthcare providers reduce claim denials, improve cash flow, and stay fully HIPAA compliant. Our AAPC-certified medical billers and coders bring years of hands-on experience supporting US-based practices across multiple specialties.
TMS Billings proudly serves healthcare providers nationwide with reliable, transparent, and results-driven outsourced medical billing services in the USA. From insurance verification and medical coding to claims submission, AR recovery, and credentialing, we handle the complete billing lifecycle so you can focus on patient care.
Compliance
Let Us Handle Your Billing,
So You Can Handle Your Patients
Focus on your patients while TMS Billings handles your billing—reducing stress, eliminating inefficiencies, and improving your practice’s financial performance.
Efficient, Custom-Fit Billing Solutions
Why practices choose TMS Billings USA
Billing doesn’t have to be stressful. Partner with TMS Billings for expert medical coding and billing services that keep your revenue flowing and your practice running smoothly.
From billing and coding to credentialing, we handle it all—so you can focus on delivering exceptional patient care.
We don’t write off the hard claims
At TMS Billings, we deliver exceptional results with a 99%+ first-pass clean claims rate and a 98%+ net collections rate—ensuring your practice gets paid faster and more consistently. Our expert team doesn’t just submit claims—we actively manage denials, follow up aggressively, and resolve issues to prevent revenue loss. With our comprehensive AR recovery services, even your old outstanding accounts receivable are analyzed, pursued, and recovered as part of our end-to-end medical billing and revenue cycle management services in the USA.
Transparent Medical Billing & Reporting Services in the USA
With TMS Billings, healthcare providers across the USA gain complete visibility into their financial performance through detailed, real-time reporting and a dedicated account manager who understands your practice. Track collections, monitor AR aging, analyze denials by payor, and understand reimbursement timelines—all in one place. Our reporting also supports provider-level insights for group practices, helping you make data-driven decisions and maximize revenue.
We Know How Medical Billing Works Across the United States
From federal programs like Medicare and Medicaid to private insurance payors, we ensure every claim meets strict compliance standards and is processed efficiently to protect your revenue. From payer rules to compliance requirements, TMS Billings handles the complexities of medical billing across the USA—so your claims are accurate, compliant, and paid faster.
Advanced Claim Scrubbing & Denial Prevention in USA Medical Billing
TMS Billings uses detailed claim scrubbing processes to detect coding errors, missing modifiers, and documentation issues before claims are submitted. Our feedback-driven approach enhances coding accuracy, reduces denials, and strengthens overall revenue cycle efficiency for healthcare providers across the USA.
Value-based payment (VBP)
As the US healthcare system shifts from traditional fee-for-service to value-based care (VBC) models, TMS Billings helps providers adapt, stay compliant, and protect their revenue.
This transition impacts reimbursement structures, quality reporting requirements, and payer contracts, and varies significantly based on your specialty and payer mix.
At TMS Billings, we support healthcare providers across the USA with:
- Value-Based Payment (VBP) models and reporting requirements
- Fee-for-Service (FFS) billing and hybrid practice workflows
- Shared savings programs and risk-based contracts
- Capitation and bundled payment models
Whether your practice operates fully under value-based care or manages a hybrid model, our team ensures accurate billing, proper documentation, and optimized reimbursement without disrupting your cash flow.
What’s included
With TMS Billings, healthcare providers across the USA receive complete, end-to-end medical billing and revenue cycle management services—without add-ons or unexpected costs.
Credentialing
AR projects and old claim recovery
Provider enrollment
Medical coding
Patient statements and collections
Denial management and appeals
Payment reconciliation, including underpayment disputes with payors
Eligibility verification (VOB)
Charge entry and claim scrubbing
Prior authorization submission and follow-up
Credentialing shouldn’t hold you back. We fast-track the process to get you approved quicker, so you can see patients without the wait.
NY-Specific Section
We work in New York’s actual billing environment
Medicaid managed care
New York runs Medicaid almost entirely through managed care. The plans — Healthfirst, Fidelis Care, MetroPlus, Affinity, WellCare, EmblemHealth, and Aetna Better Health of New York — each have their own portal, authorization workflow, and claim edit patterns. Fee-for-service Medicaid runs through eMedNY, which has its own edit library, pend codes, and documentation request process. We know the difference between a TP denial from a managed care plan and an eMedNY system edit, and we know how to fix both.
Medicare
New York’s Medicare Administrative Contractor is Novitas Solutions (Jurisdiction L). That matters for LCD compliance, ADR (Additional Documentation Request) responses, and submission requirements specific to this jurisdiction.
Personal injury / no-fault
We run the full NY no-fault workflow: NF-3 submissions, strict adherence to the 45-day filing window from date of service, managing PIP carrier denials from Allstate, GEICO, Travelers, State Farm, and Progressive, handling IME and peer review denials, and preparing AAA arbitration packets when payors push back. Miss the 45-day window and you’ve created an avoidable collection problem. Our team knows the timing and doesn’t miss it.
Workers’ compensation
New York workers’ comp billing goes through the Workers’ Compensation Board, with its own fee schedule and its own submission requirements. We handle C-4 and C-4.2 filings, CMS-1500 digital submissions through Board-approved channels, and we know the WCB Medical Fee Schedule — which varies by specialty and is entirely separate from your commercial contracts.
Audits and compliance
We work with practices navigating OMIG (Office of the Medicaid Inspector General) audit exposure, RAC audits, and the NY surprise billing IDR process, which runs under different rules than the federal No Surprises Act.
Specialties we bill for
Mental and behavioral health
Prior auth management, HARP billing, and Medicaid managed care claim patterns specific to behavioral health.
Primary care and family medicine
Everyday visit billing alongside chronic care management, preventive services, and quality-measure reporting where applicable.
Physical therapy
Same no-fault and workers’ comp depth as chiropractic, plus functional limitation reporting, cap management, and PT-specific modifier rules.
Podiatry
Procedure and diagnosis coding specific to podiatric services, including surgical and wound care billing.
Assisted living
Long-term care billing including Medicaid managed long-term care (MLTC) plans.
Pain management
Procedure-specific coding, modifier use, and documentation requirements for interventional and non-interventional services.
Chiropractic
Standard chiropractic coding plus the full personal injury and workers’ compensation workflow — NF-3 submissions, WCB filings, and arbitration when payors dispute.
Home healthcare (HHA)
RAP and final claim submissions, OASIS coding, managed care authorization tracking, and EVV (Electronic Visit Verification) claims integration and corrections.
Pediatrics
Well-visit, immunization, and developmental screening billing alongside managed care plan requirements for pediatric populations.
Hospice
Hospice election billing, room and board payor coordination, and compliance with New York’s hospice claim requirements.
Testing labs
Accurate billing for diagnostic and laboratory services, including payor-specific coding requirements and medical necessity documentation.
Platforms
No System Changes Needed — We Work in Your Existing Platform
At TMS Billings Our team works directly inside your existing platform. No migration, no changes to your front desk workflow. If you don’t have a platform, or it belongs to your old billing vendor, we can provide one.
We’re regularly working in:
- Hospital / enterprise: – Epic, Oracle Health (Cerner), athenahealth, MEDITECH, Altera Digital Health (Allscripts)
- Multispecialty / primary care: – eClinicalWorks (ECW), NextGen, Greenway Health (Intergy), AdvancedMD, Kareo / Tebra, DrChrono, ModMed, Practice Fusion, CureMD, CareCloud, and others
- Behavioral health: – TherapyNotes, SimplePractice, Valant, ICANotes, TheraNest, CentralReach
- PT / chiropractic: – WebPT, ChiroTouch, Prompt EMR, Raintree, Genesis, Eclipse, Practice Perfect
- Home health / hospice: – HCHB, MatrixCare, WellSky, Axxess, PointClickCare, KanTime, Brightree, and others.oTouch, Prompt EMR, Raintree, Genesis, Eclipse, Practice Perfect
Clearinghouses
Clearinghouses are the intermediaries that validate and route your claims to payors before
reimbursement. We work across all major clearinghouse networks, including Change Healthcare, Availity, Waystar, Office Ally, TriZetto, Ability Network, Experian Health, and all standard EDI submission channels.
If you’re on a platform not listed above, that’s not a problem. We have experience with less common systems and regularly onboard into new environments.
Frequently Asked Questions
Do you have questions about our medical billing and coding company? Let’s help you out.
What medical billing services does TMS Billings offer in the USA?
TMS Billings provides complete medical billing services in the USA, including charge entry, medical coding, claim submission, denial management, AR recovery, and credentialing. Our end-to-end revenue cycle management (RCM) solutions are designed to help healthcare providers maximize reimbursements and reduce administrative burden.
How does TMS Billings help reduce claim denials?
TMS Billings uses advanced claim scrubbing, accurate medical coding, and proactive denial management to minimize claim rejections. Our team identifies errors before submission and provides detailed feedback, helping healthcare providers across the USA improve first-pass claim acceptance rates and overall billing accuracy.
Is TMS Billings HIPAA compliant and secure?
Yes, TMS Billings follows strict HIPAA compliance standards to ensure patient data security and confidentiality. We use secure systems and best practices aligned with US healthcare regulations to protect sensitive information throughout the billing process.
Can TMS Billings work with our existing EHR or billing system?
Absolutely. TMS Billings integrates seamlessly with your existing EHR, EMR, and practice management systems used across the USA. Our team works directly within your system, ensuring a smooth transition with no disruption to your workflow.
Does TMS Billings provide reporting and analytics?
Yes, TMS Billings offers detailed reporting and analytics including collections trends, aging accounts receivable (AR), denial analysis, and payer performance. These insights help healthcare providers make data-driven decisions and improve financial performance.
Blogs
Stay Up-to-Date with Our TMS Medical Billing Insights
- Guides
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Connect with TMS Billings—your trusted partner for medical billing services in the USA—and discover how to improve cash flow, reduce claim denials, and optimize your revenue cycle.
