TMA’s free Reimbursement Review and Resolution Service goes to bat for members by helping to resolve issues related to insurance payments. Don’t waste your time filing appeal after appeal without resolution. Our team recovered more than $2.3 million for members last year. Looking for the Hassle Factor Log? You’re in the right place! The renamed Reimbursement Review and Resolution Service features additional staff experts to better serve our members.
TMA can help resolve issues with your payer network status, prompt-pay, and other reimbursement claims. Staff experts will work with your team to systematically navigate billing and coding requirements. We also meet directly with Medicare, Medicaid, health care payment plans, and large insurers to discuss specific problems that you bring to our attention.
The Texas Medical Association accepts submission to the Reimbursement Review and Recovery Service from current TMA members only. Download the Review Form which includes submission information. All physicians must also have a Business Association Agreement (BAA) on file with TMA.
Reimbursement Review Form
Business Associate Agreement (BAA)
Please observe the following guidelines to help staff expedite processing while maintaining the integrity and credibility of the Reimbursement Review and Resolution Service (RRR).
Attachments should contain only the protected health information (PHI) that is relevant to the patient(s) for which a physician is submitting a Review Form. Physicians should delete all other patient information from the attachments. TMA will return to the practice any Review Forms that have non-pertinent PHI.
Use this checklist to gather the necessary documentation for the RRR Service team.
Examples of frequently needed attachments are:
TMA adds the following types of Review Forms to its database as “informational only”:
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Billing and Coding Tips, Tools, and Resources
With varying and constantly changing billing and coding requirements, how can you and your staff know what to do? TMA’s reimbursement specialists are here to help. View TMA curated educational resources to help you keep current.
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Questions about regulations or best practices? Contact the Reimbursement Service Department at 512-370-1414 or via email.
Members can speak directly with TMA's certified coders and staff experts about regulatory compliance, billing and coding, payer reimbursement, and licensure concerns.