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This video will introduce you to the Transworld Medical Interface, or TMI, software. TMI automatically
retrieves information on unpaid claims from your Medical Manager server (usually on weeknights
after office hours), helps you decide which claims need to be turned to Transworld to
begin the series of 5 demand letters, and sends the claims you've selected to Transworld
with a few mouse clicks. As patients and insurance companies start making payments on these claims,
TMI will automatically detect payments that have been posted in Medical Manager and notify
Transworld of changes in account statuses. For example, when a self-pay claim that's
been reported to Transworld has been paid off and the payment has been posted in Medical
Manager, TMI will notify Transworld that the claim balance has been reduced to zero. If
you like, TMI can notify Transworld to send thank-you letters to patients who've paid
their claims in full.
Let's see how TMI can make your collection efforts easier and more effective. Start the
TMI program by double-clicking on the TMI or TMI-S-Q-L icon on the Windows desktop.
When the login screen appears, you'll enter the username and password that you've been
given. We'll use the built-in Admin account for this demo. After entering your password,
press the Enter key on the keyboard or click the Login button down here at the bottom right
corner of the screen. You may briefly see a message letting you know that the program
is loading, then the main TMI screen should appear.
Let's open the Pending screen by clicking on the Pending button near the top left corner
of the TMI main menu. The Pending screen is where you'll spend most of your time in TMI;
it shows unpaid claims that have been retrieved from your Medical Manager server but not yet
turned to Transworld. The bottom half of the screen shows a table that summarizes the pending
claims, and the top part of the screen shows details on whichever claim is highlighted
or selected on the table. As you click a line on the table, you'll see the details at the
top of the screen update to show the details for that claim. When you're viewing insurance
claims, the details will include the name of the insurance company (the insurance plan
number is shown to the left of the company name), policy and claim numbers (when available),
the name of the insured party and patient, and the patient's Social Security number.
By default, the Pending screen starts out showing unpaid insurance claims, if it found
any. To view self-pay claims instead, click the Patient Due button near the bottom left
corner of the screen. Note that the information at the top of the screen has changed; it no
longer includes the name of an insurance company, policy and claim numbers, etc. At the right
side, though, it includes the Date of Last Statement, the total account balance, the
amount due from the patient, and the date and amount of the last payment from the patient.
The Patient Due screen also includes some color-coding that can help you decide which
self-pay accounts to report to Transworld. Most of the claims on this screen are highlighted
in red, meaning that no payments have been received from the patient for more than 35
days. Claims that are shown in black, like the Carlson claim, have had at least one payment
in the last 35 days. This color coding can alert you to claims where the patient is making
monthly payments on their account. In rare cases, you might see a claim highlighted in
blue; that means the balance that TMI found does not match the balance in Medical Manager.
This often means that you've already reported some of this patient's unpaid balance to Transworld.
To switch from viewing self-pay claims back to insurance claims, click the Insurance Due
button at the bottom left corner. There are also buttons that allow you to view partial
payments or full payments that have been posted against claims that Transworld is already
processing. If TMI hasn't found any partial or full payments on claims that were previously
reported to Transworld, it'll display a message to that effect, then automatically move on
to the next screen that contains some claim information.
Whatever type of claims you're viewing, the buttons along the left side of the screen,
about halfway down, let you view claim details by Date of Service. When you click a button
with a date on it, a new window will pop up with entries by CPT code listed at the top,
and details shown at the bottom. When you click a line on the table at the top of the
window, all the payments, adjustments, and transfers that have occurred for that procedure
will be shown at the bottom of the window. When you're done viewing the details for this
date of service, click the Complete button at the bottom right corner of the window.
TMI will display buttons for up to 5 dates of service, but can actually provide details
for additional dates if needed. If you click on the 5th Date of Service button, the pop-up
window may include claims for additional Dates of Service.
There's a lot of information on this screen to help you decide just which claims to report
to Transworld, and TMI lets you sort the information many different ways. To sort the table at
the bottom of the Pending screen, just click at the top of the column you want to sort
by. For example, let's say that one of the providers in your practice doesn't want their
claims reported to Transworld. When you click at the top of the Dr# column, the claims will
be sorted by the doctors' Medical Manager ID numbers, letting you jump right to the
providers who do want their claims reviewed. You can also sort the table according to patients'
account numbers or names, insurance plan numbers or names, amount due (in highest-to-lowest
order), whether someone in your office has already decided whether to transmit the claim
to Transworld or not (we'll talk more about that in just a moment), and by unapplied credits.
The Patient Due screen also has a Date of Last Payment column that you can sort on.
There are lots of different ways to decide what claims you want to send to Transworld
first, but a good way to start might be to click at the top of the Unapplied column to
see which claims have unapplied credits. Once you've identified these, you can—if appropriate—use
Medical Manager to post the unapplied credits to unpaid claims. The next time that TMI automatically
retrieves information from your Medical Manager server, which is generally every weeknight,
it will detect any credits that were posted against these claims. If a claim no longer
meets your criteria for reporting to Transworld, it'll automatically disappear from the Pending
screen. For example, the minimum default claim balance to report to Transworld is $25. If
you posted this $28 unapplied credit on the Williams account to the February Date of Service,
the balance would drop to just $2, and this account would disappear from TMI the next
time it retrieves data from Medical Manager.
After cleaning up your unapplied credits, you could start looking at the biggest balances
first by clicking at the top of the Amount column. Or, when viewing self-pay accounts,
as we are here, you might want Transworld to start first with the claims that have gone
the longest without any patient payments. If you click at the top of the Date of Last
Payment column, the claims that have been paid on most recently will be sorted to the
top.
However you choose accounts, you'll use the options in the "Transmit This Collection"
box to tell TMI what action to take. The option that you choose here will be reflected in
the "Xmit," or "transmit," column. Claims on which you've not yet made a decision will
have a blue question mark for "undecided" in the Transmit column. Let's say that you
want to turn the Wittingham account to Transworld. Just click on that claim to highlight it,
then select the Yes option in the Transmit This Collection box. The Transmit column now
holds a green check mark to indicate that this claim is ready to go to Transworld, and
if you look down near the bottom of the screen, you'll see a message that shows the total
number of claims on this screen and their accumulated balance, as well as the fact that
one claim with a balance of $100 has been selected for transmision to Transworld. If
you select additional claims, the numbers at the bottom of the screen will be updated.
If you definitely don't want to transmit a certain claim to Transworld—maybe because
the doctor on that claim doesn't want to use Transworld, or the patient on that claim has
been extended professional courtesies—click the No button in the Transmit This Collection
box. If you need additional information on a claim before making a decision, click the
Hold button. This will remind you that you've seen the claim but need to research it, maybe
by pulling an EoB, before making a yes-or-no decision on it. TMI will remember your decisions
when you leave the Pending screen, and when you exit from the TMI program.
To print a list of pending claims, click the Print button at the bottom of the screen.
You can either print claims for the screen you're currently viewing—the Patient Due
screen, in this case—or for all screens, which includes insurance claims, self-pay
claims, partially-paid claims, and fully-paid claims. You can further choose whether you
want to print a list of claims that are marked Yes, Undecided, No, or Hold, or print All
claims. The Export button is used to save a list of claims as a file that can be imported
into a program like Microsoft Excel. For now, let's generate a list of patient-due claims
that have been marked Yes. The list would normally be sent to your printer, but for
the purposes of this demo, we'll display the list on-screen. When you're done printing,
click this Quit button.
To close the Pending screen and return to the TMI main menu, click the Complete button
at the bottom right corner of the window. To close the whole TMI program, click the
Quit button at the bottom left corner of the main menu. TMI will remember any Yes, No,
or Hold choices that you made on the Pending screen, so unless a claim is marked as paid,
adjusted, or transferred in Medical Manager and no longer matches your TMI criteria, it'll
be right there waiting for you the next time you run TMI.
We hope this video has been useful in introducing you to the TMI software and teaching you how
to select the claims that you want to send to Transworld. In future videos, we'll demonstrate:
how to actually send claims to Transworld, how to fine-tune the settings that TMI uses
to identify claims that need to be sent to collections, how to track claims that have
been submitted to Transworld, and how to use TMI's built-in reports.