Provider FAQ
Who is Total Medical Solutions?
What documentation does TMS need from me?
How do I submit claims for payment?
That’s so much faster than I get paid from insurance companies!How do you do it?
How can I get more business from TMS?
What are the advantages of joining TMS’ provider network?
Who is Total Medical Solutions?
Total Medical Solutions (TMS) is a medical benefits coordinator for Workers’ Compensation claims. With help from network partners, TMS provides home health care, durable medical equipment, orthotics and prosthetics, and other ancillary services to injured workers nationwide. TMS manages a growing network throughout the United States on behalf of over 100 Work Comp Insurance Carriers.
The account managers at TMS are very knowledgeable within the fields of work comp, case management, and home care. They are available to you 24/7. They hold communication between them and the providers they work with as an extremely high priority.
What documentation does TMS need from me?
- Fax the Admission/Evaluation notes to the referring TMS account manager within 2 business days of completing the Admission visit. In addition, please call the TMS account manager with a verbal report immediately after completing the Admission
- The nursing notes for each visitor shift should be forwarded to the referring TMS account manager each week. All notes must designate the type of caregiver (RN, HHA, PT, etc.), be written clearly, and be sent weekly. For the week Sunday through Saturday, the TMS account manager should receive all notes by the following Wednesday. 3. If you receive updated physician’s orders, fax a copy of the prescription to the TMS account manager within 2 business days. 4. If the care giver misses a scheduled visit due to the patient’s fault, a missed visit note should be faxed so that reimbursement for lost time may be considered.
Note: All faxes must be accompanied with the “TMS Weekly & PRN Fax Transmittal” cover sheet.
How do I submit claims for payment?
Invoices are mailed to our corporate office, ATTN: Accounts Payable. The TMS written authorization (Purchase Order) and all notes for the dates of service listed on the invoice should be attached to the invoice. Invoices are not accepted after 90 days of date of service or 15 days after the patient is discharged from your care, whichever is sooner.
What are TMS’ payment terms? TMS has net 45 day terms with home health care providers per Florida work comp statutes. Payment is sent no later than 45 days after TMS receives a clean invoice AND all nursing notes for the dates of service on that invoice.
That’s so much faster than I get paid from insurance companies! How do you do it?
Providers receive reimbursement directly from TMS as a private pay customer. TMS is responsible for collecting money from the insurance companies, so our providers save tons of time by going through us instead of trying to get reimbursed by the carrier. This means faster payment for YOU!
How can I get more business from TMS?
You can join TMS’ provider network. To receive an application, call or email Dorothy Dalton, Provider Relations Manager (see below for contact information).
Include the following information in your request:
- Legal company name
- Phone number
- D/B/A name, if applicable
- Fax number
- Physical address
- Counties serviced
- Remittance address
If you have more than one office location, send all of the above for each office.
What are the advantages of joining TMS’ provider network?
Aside from increased business volume, becoming a partner in TMS’ network has many benefits.
Some of them are:
- Reimbursement directly from an established nationwide private pay customer
- No membership fees
- Diversifying your means of revenue
- A dedicated provider-servicing department
I still have questions!
For questions regarding the case referred to you, notes/claims submission, or case management inquiries, contact the referring TMS account manager. Call our corporate office at (407) 831-7331. Be sure to have the claimant’s name ready. If you are calling after 5:30pm EST, press 2 for the Home Health Care dept. TMS account managers are available 24/7. For any questions regarding TMS’ network, partnering with TMS, or general information, contact Dorothy Dalton, Provider Relations Manager. Direct Tel: (407) 585-8306 Email: dorothy.dalton@newtms.com