Medical Billing Companies & Consultants in Tualatin, OR

MTSL Group is an Oregon revenue cycle management and provider credentialing firm that supports independent physician practices and small medical groups. The company describes itself as Portland-based and works mainly with practices that cannot justify an in-house administrative department. It handles their back-office workload, including claims, coding, collections, enrollment and staff education, so that clinicians can spend more of their time with patients.

Billing and Revenue Cycle Services

The firm offers full-cycle billing. The client's staff keep gathering patient demographics and insurance details, and MTSL takes over from that point. Every biller on its team is also a certified coder. Before submission, each charge is checked against NCCI edits, payer and government rules, and CPT and ICD-10 conventions so that modifiers, units and diagnoses line up correctly. The team has worked commercial, Medicare, state Medicaid, auto accident and workers' compensation claims for many specialties in several states.

• Coding review and claim scrubbing before submission
• Claim submission with acceptance confirmation
• Payment posting and denial follow-up
• Insurance and patient receivables follow-up
• Patient statements, plus mail and phone contact with patients
• Sending unpaid balances to collections, following each clinic's own policy
• Periodic or on-request chart audits to lower payer audit risk and catch missed charges
• Monthly financial reports for the practice

Credentialing and Enrollment

A dedicated credentialing department takes care of payer enrollment, contracting and re-credentialing for Medicare, Medicaid and commercial plans across the country, including Alaska, Hawaii and Puerto Rico. It serves medical doctors, nurse practitioners, dentists, podiatrists, optometrists, physical therapists, acupuncturists, naturopaths, mental and behavioral health therapists, and government agencies.

Its work includes Medicare revalidation, credentials verification, outsourced hospital privileging, managed care contracting, CAQH maintenance, web portal setup, and individual and group NPI registration. Payers are contacted every 30 days, and clients get a regularly updated tracking log. Annual maintenance for unlicensed behavioral health roles such as QMHAs and QMHPs is offered at a reduced rate.

How They Work With Clients

MTSL does not make practices change their electronic health record system. It runs its own practice management platform, which can link to many major EHRs for electronic processing, and it also offers cloud-based integration options. Clients can see their billing data at all times, and the firm commits to answering inquiries within one business day.

Pricing depends on the type of provider and the practice's needs, and quotes are given after an intake form is completed. Practices that would rather do their own billing can take a customized training course. Topics include account setup, benefit verification, claim scrubbing, appeals and patient collections.

Background and Team

The company was founded in 2011 by a team that had run a large medical practice before it was bought by a national organization. It has since taken its billing and credentialing work nationwide.

Its leaders include Elizabeth Russell, MBA; Mallory Espejo, CPC, CPCD, co-owner and client services director; Julia Puckett, a certified credentialing specialist who manages the credentialing department; and Matthew Jacobsen, who previously held credit, general management and COO roles. Client testimonials also mention bookkeeping, HR and business management support for some practices.