Complaint Review: TMG Health Inc.

Claims Processors are paid piece rate at TMG Health, while on the clock -  40 hour work week.  Production quota of 1000 claims per week averages to 25 claims per hour  or 2.4 minutes per claim to review information, research, price and adjudicate the claim.  Often the computer system is slow and takes longer than 2 minutes just to update the claim before you can process it.    There is an accuracy standard to be maintained of 95% each week as well.   Audits are ongoing by several sources: QC , internal audits, clients, and Medicare.

Piece rate ranges from .20 to .81 cents depending on the type of claim.    If you have to research a claim to verify pricing you don't get the higher rate for processing the claim if you don't have to change the price - even though you receive a system warning telling you to check the price.   Researching a price can take several minutes because you have to use multiple tables (often more than 3) and websites to verify the claim.   You lose time and money (because they won't pay you for your research) for these claims.   You are often at the mercy of the speed of their system or the internet itself.

If you have to actually price a claim and then have to pend it to another department,  you don't get paid for that either. They will only pay you for the pend portion of the claim (20 cents) and not the manually priced rate of 61 cents.   If you have to pend it to several different departments, you only get paid once to pend it, even though after each pend you have to do something else to the claim and pend it to another department. 

You also have to spend anywhere from 10 to 30 minutes reading work emails daily that they refuse to Pay you on the clock for, regardless that it has to deal with how you process particular claims. Often they are work agendas for the day, training issues, or questions regarding particular claims.  You are working emails for FREE - losing money because you should be spending that time processing claims at piece rate.  

They keep their pay rates low so they can keep their production cost low for their clients.  

Turnover at TMG is phenomenal -   They are constantly seeking Claims processors due to people leaving for better work and MUCH better pay.   There were over 30 processors in my training class, and after 1 year only 2 remain (as far as I know they are still there).   New classes begin about every 6 weeks because of the loss of workers that continually quit because of their often unobtainable quotas.  They treat their employees like unskilled laborers, vassals and doormats.

TMG management is also deceptive during the interview process.   They explain to you the piece rate process, showing you one set of prices and goals,  and then when you are hired and complete training,  the prices, goals and process changes to benefit them, not you.  They hire people with Healthcare training and experience but do not afford them the respect or dignity that their education and experience affords them elsewhere.

Their system that gives you the claims to work and report from is flawed -  it often has an update lag time of over 36 hours, thusly effecting your quotas for a particular given week.  Often the system loses your claim numbers and does not report the claims being done at all.  Again,  this can  effect your weekly quota, not to mention your pay depending on the claim type that is lost.