In today’s environment reimbursement continues to decline coupled with increased regulatory oversight hence it is necessary for physicians, patients, and the healthcare industry to be efficient. Hence Central Billing Office (CBO) is the answer as it improves efficiencies in billing, payment posting as well as enables enhanced customer service and seamless patient experience.
Now let’s understand what is Central Billing Offices and their benefits:
Knowing your Central Billing Offices and role of staff
It is a type of arrangement where physician billing (PB) and hospital billing (HB) are combined into one operation. The primary purpose behind CBO is to create an office where patients can call to discuss both hospital and professional billing services. Moreover, It is easier to standardize, monitor, and make sure follow-up is done consistently By having centralized billing,
Staff is an important part of your CBO as specialized staff with payers know the nuances of the plan and become familiar with its policies, contracts, and even personnel. The established personal relationship helps staff to conduct claim follow-up over the phone only.
As already mentioned CBO helps to ensure efficiency with planning, accountability for instance, if CBO does not have access to patients’ medical records, it is crucial for the front-desk staff to thoroughly and accurately collect data needed by the CBO to resolve claims (e.g., insurance eligibility, provider number, patient demographics, etc.) and hence CBO will make it easier to hold staff at individual sites accountable.
CBOs bring together a concentration of expertise which offers dramatic results. If you have all of your best and brightest mind billing personnel in one place than spreading them out then these people will better able to collaborate and complement one another.
Over the last fifteen years, the healthcare industry observing a trend where numerous physicians’ offices have been snapped up by hospitals and larger networks.
Role of Central Billing Offices in merging physician
During the merging process of physicians, CBO needs to contact all of the commercial insurance companies and deal with a lot of paperwork. Moreover, patients need to be made aware of the change as well as every patient needs to receive a letter informing of the switch if the physician’s office is relocating.
The switch from one billing system to another is evident during the merger process and CBO needs to make this process smooth. This may require new commercial insurance company contracts which are having matching terms with the rest of the network. If those payment amounts and codes remain different, this information needs to be noted, or else the current claims will be submitted incorrectly.
Clearance of Unpaid and underpaid claims from CBO
An important role of CBO is it needs to clear up all of those unpaid and underpaid claims because these underpaid claims are a hindrance to the new provider network. While looking at underpaid and unpaid claims every CBO has only three state-level appeals for those unpaid and underpaid claims.
It is very prominent that many hospitals and physicians’ offices simply give up after all of them have been rejected. When you consider that some of these big hospital and office networks end up going bankrupt because they have too many debts and not enough positive cash flow, The reason is those unpaid and underpaid claims.
However, the ERISA process can help to recover that unpaid and underpaid claims. But most of the time many provider networks and hospitals are hesitant to go through the ERISA process.
Lastly, we need to anticipate the CBO impact on cash flow as we need to invest money to make money with the central billing office (CBO). Even though there is a lot of work that goes into consolidating your offices CBO well worth it in the end.
We Medical Billers and Coders (MBC) are a medical billing company and we are always ready to work with you in considering the pros and cons of centralization. We will help you in all your medical billing and coding process.
FAQs:
1. What is a Central Billing Office (CBO)?
A Central Billing Office is an integrated operation that combines physician and hospital billing to streamline processes and improve patient service, enabling efficient management of both hospital and professional billing.
2. What are the benefits of using a CBO?
CBOs enhance billing efficiency and payment posting, improve customer service, standardize processes, and provide better accountability among staff, ultimately leading to a seamless patient experience.
3. How does a CBO facilitate mergers in healthcare?
During mergers, a CBO coordinates communication with commercial insurance companies, manages the transition of billing systems, and ensures that patients are informed about changes, streamlining the merger process.
4. What role does a CBO play in managing unpaid and underpaid claims?
CBOs focus on clearing unpaid and underpaid claims that can hinder cash flow, utilizing processes like ERISA appeals to recover these claims, thereby improving the financial health of provider networks.
5. What expertise do staff in a CBO bring to the billing process?
Staff in a CBO possess specialized knowledge of payer policies, contracts, and billing nuances, which enhances claim follow-up efficiency and improves collaboration, ultimately leading to higher reimbursement rates.
