Episode Details

In this episode of the Ask MGMA podcast, hosts Daniel Williams and Cristy Good discuss strategies for sizing a central billing office (CBO) to ensure efficient accounts receivable (AR) management and claims processing. Christy, an MGMA expert, shares key insights and best practices to help medical practices determine the right staffing, technology, and processes to optimize their CBO operations.

Key Takeaways:

1. Assessing Current Volume and Complexity

• Evaluate historical data on claim volume and billing procedures to determine appropriate staffing levels.

2. Leveraging Technology

• Integrate billing and coding software with the practice's EHR system to streamline claims processing and reduce errors.

3. Training and Monitoring Staff

• Provide ongoing training to billing and coding personnel to stay up-to-date on regulatory changes and ensure quality control.

4. Pre-Submission Claim Scrubbing

• Implement a robust pre-submission claims review process to catch and correct errors before submission.

5. Regular Audits

• Perform both internal and external audits to validate coding standards and payer requirements.

6. Effective Patient Communication

• Develop clear financial policies and scripts to help patients understand their financial responsibilities.

7. Outsourcing Considerations

• Evaluate the benefits of outsourcing billing and coding functions, especially for smaller practices.

8. Adjusting Strategies for Seasonal Changes

• Adapt Central Business Office (CBO) staffing and processes to accommodate fluctuations in patient volume and claim complexity throughout the year.

Resources and Call to Action:
For more information and support in optimizing your practice's central billing office, visit MGMA.com and explore our wide range of resources, including:

• MGMA Consulting services for customized guidance
• MGMA Benchmarking data for industry insights
• MGMA Coding and Billing Toolkit for regulatory updates

If you have a specific question or challenge, use the "Ask MGMA" feature on MGMA.com to connect with our experts, like Cristy Good, who can provide personalized assistance.

Sponsor:
Capella University helps healthcare professionals earn their MHA on their terms. Their FlexPath MHA program is designed for busy MGMA members who want to advance their leadership skills with a flexible, self‑paced format — often faster and more affordably — without putting their careers on hold. Questions? Visit capella.edu/MHA to learn more.