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Sample Financial Dashboard - 10/28/2024 7:43:03 PM

Specialty (per FTE physician) Median Median % LAST YEAR THIS YEAR YTD customize these blocks FINANCIAL MEASURES Benchmark Benchmark Practice Practice Gross Charges Adjustments Gross Collections Adjusted Collections Tota...
Referrals Telemedicine - 9/17/2024 9:39:01 PM

Telemedicine Referrals Purpose To ensure an efficient referral process by which patients participate in telemedicine services. Policy Patients referred to distant-site providers for telemedicine services have appropriate documentation comple...
Provider to Provider Communication telemedicine - 9/17/2024 8:57:09 PM

Provider-to-Provider Communication Purpose To ensure that patient information is communicated between providers in conjunction with effective patient care coordination, and in a manner that respects the patient’s privacy. Policy This pract...
Administration and Billing Telemedicine - 9/17/2024 6:49:54 PM

Administration and Billing Purpose To ensure that the provision of telemedicine services is financially sustainable. Policy The practice bills telemedicine services to the patient, or to the patient’s insurance, whichever is appropriate. Th...
It Takes a Village: TMA Works Arm in Arm with Other Organizations - 9/13/2024 7:24:23 PM

TMA’s relationships with a diverse set of key organizations enables TMA to provide comprehensive services in more innovative ways that it could on its own. County Medical Societies are the cornerstone to TMA’s strong grassroots connection to the pra...
‘TMA Health Beat’ Explores Aging Patient Population’s Unique Needs - 8/21/2024 6:48:20 PM

Texas expects to see a nearly threefold increase in people aged 65 and older by 2050, according to the Texas Demographic Center, making it crucial for physicians to learn the unique care needs of this population. TMA’s newest podcast ser...
TMA Backs Banning Discretionary Clauses - 8/15/2024 8:36:13 PM

TMA is asking State Insurance Commissioner Mike Geeslin to use his discretion and ban Texas insurance companies from hiding behind discretionary clauses in their policies. Such clauses, already outlawed in 22 states, give the insurers free rein to in...
State Plan Tackles Mental Health Coverage - 8/9/2024 7:41:35 PM

Four years after the Texas Legislature passed legislation aimed to improve health plan coverage of mental health conditions and substance use disorders, a state workgroup has released a strategic plan to improve compliance with the law’s...
TMA Resources: Understanding Insurance and Policy in Health Care - 8/9/2024 7:40:02 PM

TMA resources to help students improve readiness for understanding the role of insurance and policy in health care. Health Insurance: Insurance Overview Affordable Care Act Overview Physician Prices, Fee Schedules, and Managed Care ...
Workers' Compensation Advocacy - 6/18/2024 3:07:56 PM

Advocacy In Action | Sample Letters | FAQs Regarding HB7 and Workers' Compensation Reform | Resources TMA's Workers' Compensation Advocacy in Action Provider Resources (TDI)...
TMA Urges Framework for Innovative Coverage, Cancer Prevention to Senate Committee - 5/21/2024 5:39:55 PM

Armed with interim charges, the Texas Senate Committee on Health and Human Services recently held its first hearing in the runup to the 2025 state legislative session. The Texas Medical Association was a key participant, offering recommendations...
5.14.24 TMA Written Testimony - Insurance for SHHS - 5/14/2024 5:10:15 PM
New Federal Rules Limit Short-Term Insurance Plans, Enhance Protections - 4/17/2024 5:52:34 PM

Following advocacy by the Texas Medical Association, the U.S. departments of Health and Human Services (HHS), Labor, and the Treasury recently issued final rules that strengthen consumer protections related to short-term, limited-duration insura...
Novitas Solutions Warns of Top 10 Medicare Claims Errors - 4/15/2024 4:08:15 PM

Novitas Solutions, the Medicare administrative contractor for Texas, has released a top 10 list of errors made between January and March 2024 physicians should be aware of to mitigate billing problems in their practices. If left uncorrect...
The Trust Model: For Decades, TMA's Insurance Trusts Have Put Physicians First - 4/9/2024 5:11:25 PM

Wendy Parnell, MD, first learned about the Texas Medical Association Insurance Trust (TMAIT) after residency when she joined a private practice founded by her father and godfather that is a policyholder to this day. Soon ther...
TMA Moment in Time: Texas' First PPO Rules - 4/9/2024 5:10:57 PM

When preferred provider organizations first emerged on the health plan market in the early 1980s, they veered sharply from traditional insurance models and prompted concerns from physicians. Former Texas Medical Associati...
TMA to IRS: Direct Primary Care, Health Care-Sharing Ministries Aren’t Insurance - 4/5/2024 6:36:38 PM

The Texas Medical Association is urging the IRS to reconsider a proposed rule that would classify direct primary care (DPC) arrangements and health care-sharing ministries (HSMs) as insurance. The IRS proposed rule was issued in June as a resul...
TMA Sues Feds Over Unfair Rule for Surprise Billing Law - 3/22/2024 8:39:02 PM

Oct. 29, 2021 Rule ignores statutory text and congressional intent, shrinks access to care for patients [Austin, TX] -- The Texas Medical Association (TMA) filed a lawsuit in federal district court in Tyler, Texas, after the Biden...
Protections for You and Your Choice - 3/19/2024 6:20:14 PM

Sample Complaint Form When an insurer or health plan refuses to pay for medical treatment, patients and their families must carry the burden of paying for the doctors, laboratory tests, and hospitals. But the risks are higher, an...
Physicians Benevolent Fund Bolstered by TMAIT Gift - 3/14/2024 4:49:54 PM

In an effort to support physician well-being, TMA Insurance Trust (TMAIT) has announced a donation of $15,000 to The Physicians Benevolent Fund (PBF) to help provide crucial assistance to physicians and their families during times of need. TMA...
Texas Agencies - 3/12/2024 6:35:00 PM

Office of Texas Attorney General Office of the Governor Texas Legislature Online Texas Department of Insurance (TDI) TDI Physician/Provider Complaint Form Texas Department of Aging and Disability Services (DADS) T...
Resident and Fellow Membership Benefits Page - 2/28/2024 6:13:19 PM

Texas Medical Association Resident and Fellow Exclusive Member Benefits The Resident and Fellow Section (RFS) is an organized membership section of TMA that helps address issues unique to Texas resident physicians and provides a forum for residents ...
Rural Physicians - 2/16/2024 7:50:11 PM

The enormity of Texas is a source of great pride, but it also can serve as a great obstacle for those seeking and providing health care. Approximately 15 percent of Texas' population lives in rural counties, yet only 9 percent of primary c...
TMA Insurance Trust - 2/15/2024 4:56:18 PM

Four Exclusive Member Advantages From TMA Insurance Trust Like other insurance agencies, TMA Insurance Trust is a full-service insurance agency with a staff of professional agent-advisors who have years of experience. But tha...
Novitas Solutions Names Top Ten Medicare Claims Errors - 1/17/2024 5:48:02 PM

Novitas Solutions, the Medicare administrative contractor for Texas, has cautioned physicians to be aware of the top 10 most common claim submission errors made in 2023. If left uncorrected, these common errors will lead to denied claims...
Table of Contents: November 2023 - 1/5/2024 7:24:24 PM

Volume 119, Number 9 - November 2023 The Medicaid Issue14 First Steps: TMA helped secure the first Medicaid physician rate increases in decades in hopes it will build momentum for future gains. By Emma Freer20 On the Mend: Twelve months of postpartum...
Private Insurers Must Cover Surveillance Colonoscopies, TMA Urges Feds - 1/3/2024 9:49:05 PM

To uphold the established standard of care for colorectal cancer screening, commercial insurers regulated by the Affordable Care Act (ACA) must cover follow-up surveillance colonoscopies that take place after the removal of precancerous polyps or les...
Your Billing and Collections Checklist for 2024 - 12/19/2023 7:22:51 PM

TMA’s Reimbursement Services staff work year-round with physicians and health plans to help make sure you get paid correctly and on time. They’ve put together a list of practical actions you can take at the start of 2024 to keep your billing and coll...
Closing the Gap: New Texas Network Adequacy Law Tackles Waivers - 12/4/2023 8:10:19 PM

Austin plastic surgeon Elisabeth Potter, MD, routinely cares for breast cancer patients and survivors from as far away as El Paso and Amarillo. “I’m seeing patients having to travel upwards of four hours to see a reconstruction surgeon who takes the...
CMS Strengthens Price Transparency for Hospitals - 11/29/2023 5:43:15 PM

A new Centers for Medicare & Medicaid Services (CMS) final rule aims to strengthen hospital price transparency regulations for 2024, a move physicians hope will address weaknesses in prior policy that hindered them and patients from making inform...
TMA Advocacy in Agencies - 11/9/2023 11:35:10 PM

Newcomers to Texas Visit your one stop location to get information on the licensure process, physician demographics, credentialing application, establishing your practice, state and federal agencies, resources for your practice and much mo...
The Texas Medicare Manifesto II - 11/2/2023 5:16:48 PM

By TMA President Josie R. Williams, MD Every year, for almost a decade, organized medicine and Congress go through the same tedious motions. Physicians plead with Congress: "Fix the faulty funding formula Medicare uses to pay physicians: ...
Publications - 10/3/2023 9:37:30 PM

Every year, TMAF releases an Annual Report as well as SOLUTIONS, our semi-annual newsletter. Annual Report Report on previous year published each summer. 2017 Annual Report SOLUTIONS: TMA Foundation's Newsletter Information about TMAF ac...
Sections to Meet, Mix, and Work at Business of Medicine Conference - 9/25/2023 5:23:39 PM

Don’t forget to register for the Texas Medical Association’s inaugural Business of Medicine Conference and RSVP for section activities. View the section business meetings schedule. At each meeting, members will discuss resolution ideas for pot...
Proposed Mental Health Payment Parity Rules Could Restrict Treatments, TMA Tells TDI - 9/6/2023 9:50:48 PM

Proposed rules that would require insurers to cover mental health and substance use disorders at the same rate as other medical procedures could actually exclude or restrict all benefits for certain treatments. That is the message the Texas Me...
With You All the Way - 9/6/2023 2:25:54 PM

TMA supports you in every stage of your career, in all practice settings. Medical Students | Resident/Fellows | Young Physicians | Physicians Medical Students Low-interest loans and scholarship...
Meet With Your Section at Business of Medicine Conference - 8/15/2023 2:06:23 PM

Each special interest section will host an in-person business meeting during the Business of Medicine Conference, formerly Fall Conference, to take place Oct. 5-7 at the Hyatt Lost Pines Resort in Bastrop. To reserve your spot, RSVP. Mee...
TMA News Releases - 8/4/2023 3:49:23 PM

Please click to see all current TMA News Releases by subject area. _#55#_S Releases by Topic Advisories Health Insurance Issues Medicaid and CHIP Medicare Physician Practice Issues Public Health COVID-19...
Health Insurance Issues News Releases - 8/4/2023 3:47:32 PM

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Preauthorization Denial: What’s Your Recourse? - 7/25/2023 6:29:43 PM

So a health plan has denied your preauthorization request for a patient’s treatment. What options do you have? First determine the patient’s type of coverage. Medicare Advantage plans have specific appeal guidelines, which you can find on the Cente...
Legislative Victories - 7/20/2023 7:35:06 PM

TMA stands united to protect you, your family, and the profession of medicine for generations to come. Grassroots efforts have been the cornerstone of our success throughout the years. Although your elected speakers, officers, trustees, and ot...
More 'Business Skills' Resources - 7/19/2023 8:48:19 PM

"TMA has opened doors for me professionally I never knew existed. TMA’s invaluable leadership and business education services led me to co-found my own emergency centers. My professional life has been fast-tracked in just five short years post-reside...
2023 Physician-Led Legislative Results - 7/5/2023 5:26:39 PM

Corporate Practice of Medicine Protections E-Cigarette Regulation Insurance Network Adequacy and Protecting Texas’ Surprise-Billing Law Medicaid Coverage for Women and Children Medicaid Rate Increase Medical Liability Reforms Scope-of-Practice...
TMA Offers Remedies to Ease Surprise Billing - 6/28/2023 10:40:25 PM

June 8, 2016 Texas patients sometimes feel the pain from unexpected out-of-pocket costs not covered by their health insurance, known as “surprise billing” or “balance billing.” The Texas Medical Association (TMA) is taking aim at the problem, whi...
Physician-Led Results: Insurance - 6/21/2023 4:50:45 PM

TMA Priority: Build on the success of last session’s gold-card law by advancing further prior authorization reform. Recap: Carrying the torch from last session, the Texas Medical Association followed up on its 2021 gold-card success&...
Scope, Insurance, Vaccine Battles Ramp Up in Session’s Final Weeks as Women’s Health Bills Progress - 5/14/2023 9:29:47 PM

With just 17 days until “sine die,” the adjournment of the regular state legislative session, the Texas Medical Association has been mounting a tough defense against problematic bills related to scope-of-practice expansion, insurance practices, and C...
TMA Legislative Priorities Gain Traction as Key Deadline Nears - 5/4/2023 5:19:55 PM

Texas House bills must clear the lower chamber by May 11 – or face a likely death this session. In the runup to this deadline, the Texas Medical Association is working furiously to ensure medicine’s priority legislation clears this hurdle without get...
TMA Asks AMA to Stay Out of Affordable Care Act Suit - 5/2/2023 10:08:31 PM

CHICAGO — Leaders of the Texas Medical Association on Tuesday publicly objected to the American Medical Association’s plans to get involved in a high-profile federal lawsuit — filed in Texas — challenging the constitutionality of the Affordable Care ...
312522 FTAC Postcards INSURANCE - 5/1/2023 5:58:24 PM
88th TX Leg 4-11-23 TMA Testimonyby DrTildenChildsIII HB3359 Bill Would Ensure Health Insurance Networks Have Sufficient PhysiciansProvidersNearby - 4/11/2023 5:30:40 PM