Medical Billing Services

Today, more than ever, healthcare providers need the premier partnership skills California Business Bureau, Inc. and its Medical Billing Services division (MBS) are able to provide. We understand client needs and have the technology, expertise, experience, and responsiveness to improve and optimize your resources in an ever-changing healthcare environment.

California Business Bureau, Inc. has responded to this environment through a number of services designed to accomplish those goals.

  • Outsourcing of Receivables

CBB established the Medical Billing Services division to manage accounts that are either part of a pre-collect/early placement program or are referred for third-party billing, follow-up and collection service. MBS acts more as a billing service, rather than as a traditional collection agency. One key to its activities is flexibility, which allows us to be creative in structuring our services to meet the needs of each and every client.

  • Some of the highlights of the MBS approach include:
  • Increased cash flow
  • Reduced rates
  • Early billing of receivables (whether insurance or patient responsibility)
  • Ability to appeal and pursue underpayments by insurance/contracts
  • Increased return percentages
  • No rate increase for bad-debt transfer to CBB
  • Specially designed reports and tracking capabilities
  • Unique and project-specific services

MBS is able to respond to just about any type of billing requirements, whether on a continual or project-specific basis. This includes insurance accounts, self-pay accounts, and a variety of other specialty services.

  • Insurance Accounts

The highly qualified, hospital-trained and –experienced medical insurance billers in the CBB/MBS Insurance Department regularly monitor assignments to determine if there is any third-party liability. Our staff is trained in all areas of insurance reimbursement, including underpayments or short-pays by insurance or the contract administration; commercial, HMO, and PPO payments; worker’s compensation; liens, including government billing; and follow-up that may include an appeals process.

If it is determined there is a balance due from a third party, MBS will promptly generate a bill and/or follow upon a previously submitted billing by the client. This process also ensures compliance with all contracts the client is engaged in. Once the insurance has been paid, MBS will report to the client and/or adjustment or write-offs the account may need in accordance with the benefits paid. If there is a patient portion remaining to be paid, this balance will be referred to an MBS Cash Collector for prompt payment and final resolution of the account.

  • Self-Pay Accounts

MBS is able to accept accounts as early as one day after the bill has been dropped.
Our staff will work with the financially responsible party, using a lighter approach and acting as an extension of your business office. Once our Cash Collector receives an account, the financially responsible party will receive a series of appropriately prepared letters and follow-up phone calls. Our collectors are trained to apply professional and skillful techniques designed to encourage the responsible party to promptly resolve their account(s).


The earlier the accounts are assigned to MBS, the shorter the billing and collection cycle – allowing for quicker payment and greater return. MBS does not add interest to the principal balance of the account, nor is the account reported to a credit bureau. Our contract specifies that the initial rate upon assignment to MBS will remain the same for the life of the account, even when they are written off to CBB for bad debt collection. In effect, MBS manages the accounts while making every effort to resolve them while they are still in MBS. However, if an account is determined to be uncollectible, the account – upon the client’s approval – will be rolled over to CBB for bad-debt collection.

  • Other Specialty Services

MBS is qualified to provide a number of other client services. These include:

— Working and re-working one-time or ongoing special backlog projects until there is full resolution.

— Obtaining complete and accurate insurance information from patients and sharing this information with the client in an “Insurance Verification” format. Clients may then choose to bill the insurance carriers themselves or allow MBS to efficiently process the claim filing on their behalf.

— Pursuing third-party liability accounts, such as accounts involving auto accidents or personal injuries.

— Identifying potential charity accounts by submitting a client-specified charity application. As part of this service, MBS obtains all documents for the client to determine if the account(s) fall within the charity guidelines unique to each facility.


Medical Billing Services: Features and Benefits

The Medical Billing Services division of California Business Bureau, Inc. was established to management accounts that are either part of an Early Placement Program or referred for third-party billing, follow-up and collection services. The creation of MBS provides a number of features and resulting benefits for clients:

Features

Benefits

Reduced commission fees with no rate increase if transferred to CBB for bad-debt collection

Increased revenue for the client.

MBS is independent of CBB, giving it the image you want for an early placement/billing service.

The patient believes MBS is an extension of the client’s business office, rather than a collection agency – thereby softening any public relations concerns.

Early billing of receivables.

A shorter collection cycle, leading to expedited reimbursement.

Reduced workload for the client, since MBS becomes your business office support center.

Reduced expenses, enabling client to reduce or reassign staff.

Trouble-free transfer to bad debt.

Greater convenience to the client, since there are no time delays.

Billing Schedule

Perhaps the best way to provide an idea of the way MBS operates is to provide an overall look at a typical billing schedule, from the time an account is initially reviewed until such time as an accounts may be referred to our Cash Collectors for follow-up.

  • Initial Account Review
    Each account is analyzed to determine its financial classification, the extent of any prior work performed on the account, and the next step necessary to establish timely billing and follow-up. The financial classification of the claim is also considered when establishing billing and follow-up procedures.

  • Billing Verification
    MBS telephones third-party payors on all accounts to verify that they have been billed. If they have, follow-up steps are scheduled. If they have not, MBS promptly generates a bill and schedules follow-up for 15 to 30 days, depending on the financial classification. At the time of the billing, all necessary and applicable attachments are included, such as authorizations, certifications and medical records.

  • Contractual Write-Offs
    Once the insurance company pays the claim, the account is then reviewed again for any pending contractual write-offs. MBS then makes recommendations to the client prior to any patient balance billing.

  • Government Billing
    Government billing is given special follow-up scheduling. Medi-Cal accounts are verified via the AEVS process. Depending on the client’s instructions, the Medi-Cal biller will either notify the client of the patient’s eligibility or request medical records from the client in order to initiate a Treatment Authorization Request (TAR) from the field office. Once the approved TAR is received, the claim is billed immediately and a 30-day follow-up date is entered into our computer system. For claims over the one-year billing limit, a 45-day follow-up date is entered into our computer system. If no payment is received, a claims inquiry is submitted to ensure timeliness. Once the claim is paid, any contractual write-off is recommended to the client for account closure.

  • Cash Balances
    Any accounts with remaining cash balances are referred to our Cash Collectors for follow-up.