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Mark Spielman, Director of Marketing
The Alternative Billing Service
Challenge
TABS’ early success was built on deep chiropractic billing expertise — but that specialization became a constraint as its clients adopted disparate EHRs and looked for integrated billing solutions. TABS faced: churn risk, operational friction and limited scale to manually accommodate for multiple EHR systems across it's customer base. TABS needed a way to: standardize workflows across clients, support multiple specialties without rebuilding systems and grow without scaling headcount at the same rate.
Solution
TABS standardized its entire operation on Tebra, using Billing, Clinical, Engage, Robotic Process Automation, and AI Note Assist to support practices across specialties. By training staff on a single platform and leveraging Tebra’s onboarding, templates, and support teams, TABS built repeatable processes that scaled with growth. “We trained and grew our staff on one system—and that changed everything,” Spielman said.
Results
Since standardizing on Tebra and joining its Partner Connect referral program, TABS has expanded to 250 active clients, 45 employees, added new specialties, and generated consistent six-figure annual growth. Internally, standardizing on one platform reduced training burden, accelerated onboarding, and eliminated thousands of hours of operational friction and inefficiency. In fact, beyond the referral business, TABS is estimated to save nearly * $170,000 a year in hidden costs by standardizing on Tebra.
When Mark Spielman joined the family business right out of college in 2009, TABS was a chiropractic-focused billing company, deeply familiar with chiropractic codes, payer rules, and reimbursement nuances. But as government incentives drove EHR adoption, many providers began prioritizing billing partners who could support both billing and EHR workflows together.
Early on, TABS supported billing across multiple EHRs, including Raintree and others that were limited on specialties. While this allowed flexibility for their clients, it came at a cost to their business: staff had to constantly context-switch between systems, learn new workflows, and troubleshoot platform-specific issues.
Choosing an all-in-one billing + EHR platform
In 2016, TABS evaluated platforms that could support:
- Integrated billing and EHR workflows
- Multiple healthcare specialties
- Long-term scalability as client needs evolved
They chose Tebra for its unified platform and broad specialty support, allowing TABS to align billing workflows directly with client EHR data.
“We needed a platform that could grow with us and with our clients. Tebra gave us that foundation,” said Spielman.
Expanding beyond chiropractic
After two years on Tebra, TABS realized the platform’s built-in specialty support made it easier to move beyond chiropractic billing. Rather than building or maintaining custom workflows per specialty, TABS leaned into Tebra’s expertise while systematically learning the billing rules, codes, and criteria for additional provider types.
“Tebra’s web-based architecture and expanding template library made it possible for TABS to support more than just chiropractic offices. We leaned heavily on Tebra in the early years,” Spielman said. “We always had someone we could go back to when we needed help.”
By also standardizing all its customers on Tebra, this approach allowed the company to expand its client base without increasing operational complexity at the same pace.
Providing a better staff experience
As the company grew, TABS’ strategic decision to bill exclusively on Tebra simplified staff training and reduced administrative overwhelm. Staff are trained on one system, onboarding follows a consistent playbook, and new hires ramp faster without needing to learn multiple EHRs. All of which is critical since the business has recently expanded to 45 employees in the past few years alone.
Partner Connect Unlocks Scalable Growth
In 2020, TABS joined Tebra’s Partner Connect program, opening the door to direct billing services referrals from healthcare providers already using Tebra, as well as online referrals looking to replace their EHR and add a billing partner.
With standardized onboarding, billing, and support workflows:
- New clients could be onboarded faster
- Staff spent less time resolving system mismatches
- Growth became operationally sustainable
“I think everyone underestimated what this partner program could do. Not only did we get direct referrals from Tebra, but there were also a ton of providers looking for a billing company and to replace their existing EHR systems ranging from Athena to eClinical and more,” added Spielman.
The result was a consistent inflow of new customers—averaging 50 new healthcare clients per year—and a clear path to six-figure revenue growth.
“Tebra’s Partner Connect changed the trajectory of our business,” Spielman continued. “Because we already knew Tebra inside and out, we could move fast and support new customers exceptionally well.”
Growing forward, together
Today, TABS positions Tebra as the operational backbone that enables billing recovery.
Spielman says that most independent practice owners he speaks with are burnt out. They are coming from a bad situation with no Revenue Cycle Management and are scrambling to pay bills and get insurance reimbursement.
“They aren’t operations experts, they want to focus on treating their patients. So, once we get involved we can help and consult. I tell them that automation, integrated patient payments, and standardized operational workflows reduce manual task work while helping providers stabilize their accounts receivables more quickly. Most make a purchase decision on the spot, the need is so great, and our experience with Tebra is so strong,” said Spielman.
“For TABS, growth is the goal,” Spielman concludes. “And Tebra lets us keep growing without breaking our team.”
Hidden Costs Avoided
Calculation Assumptions: billing staff: 45 employees; admin/data entry/billing specialist blended rate: $30/hour; Workdays/year: 240
| Hidden Cost Area | Time Assumption | Equation | Annual Cost Avoided |
| Client onboarding inefficiency mapping billing to multiple EHRs | 12 hrs per onboarding × 50 new client onboardings/year | 12 hrs × 50 clients × $30/hr | $18,000 |
| Multiple system overhead | Daily operational friction at least 10 minutes a day | 10 min/day x 240 days/yr x 45 staff x $30/hr | $54,000 |
| Billing exception handling and rework | 1 hour/week per staff member on rejected claims, chasing data, etc. | 1 hr/wk × 48 weeks × 45 staff × $30/hr | $64,800 |
| Client support time | Custom reports, translating billing outcomes, client education on non-standard workflows: 30 min/week | .5 hr/wk x 48 weeks x 45 staff x $30/hr | $32,400 |
| Total Hidden Costs Avoided | 5,640 hours/year | 5,640 x $30/hr | $169,200/year |
Products used in this case study
Insights for independent healthcare practices
