Accounts receivable management is the backbone of a healthcare practice’s financial health, and a well-run central billing office (CBO) can make all the difference. In this episode of Ask MGMA, host Daniel Williams speaks with MGMA expert Cristy Good about best practices for structuring and optimizing a CBO, including staffing, technology, training, and audits to improve efficiency and reduce claim denials.

Key Takeaways:

• Assessing Claim Volume and Staffing Needs – Analyze historical data to determine the appropriate size and structure for your CBO.
• Leveraging Technology – Integrated billing and coding software can streamline claims processing and reduce errors.
• Training and Pre-Submission Scrubbing – Regular training and a strong pre-submission review process help prevent costly claim denials.
• Conducting Regular Audits – Internal and external audits ensure coding accuracy and compliance with payer requirements.
• Improving Patient Communication – Clear financial policies and upfront conversations reduce misunderstandings and improve collections.
• Flexible Staffing and Outsourcing – Adjusting staffing during high-volume periods and outsourcing specialty coding can help maintain efficiency.

Key Performance Indicators (KPIs) to Monitor:

• Days Sales Outstanding (DSO) – Measures the time it takes to collect payment.
• Average Days Delinquent (ADD) – Tracks overdue payments and potential staffing gaps.
• Accounts Receivable Turnover Ratio (ART) – Evaluates efficiency in converting receivables into cash.
• Collection Effectiveness Index (CEI) – Assesses the overall success of the collections process.
• Initial Denial Rate – Helps identify inefficiencies in claim submission.
• Staff Productivity – Measures the number of claims processed per staff member.

Resources: 

• For more information and support on effective KPI tracking and optimization, visit MGMA.com and explore our wide range of resources, including these resources: 

• MGMA DataDive: A comprehensive benchmarking tool that provides detailed metrics on network utilization, enabling practices to compare their performance against industry standards.  

• Even Better Data, Better Decisions: Advanced Business Intelligence for Medical Practices: This book offers techniques to integrate data for actionable insights, enhancing efficiency, profitability, and adaptability in medical practices while improving patient care. 

• Ask an Advisor: For personalized guidance, practices can reach out via email at [email protected] to connect with MGMA experts. 

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.