Spokane-based CBO has hired Pat Atwal as the revenue cycle management company’s new CEO, who she says will be responsible for scaling operations and services and expanding customers.

Atwal says, “I realized it was just the perfect thing at the right time for me.”

CBO is an acronym for Central Billing Office. The company, which has been wholly owned by Spokane-based Inland Imaging LLC since 2013, provides outsource billing and revenue-cycle management for critical access hospitals and associated rural health clinics, says Atwal.

“It’s typically a very specialized area,” she explains. “If you think about it, everything that we’re doing is helping to get cash in their hands more quickly.”

The company is located on the top floor of the three-story office complex at 801 S. Stevens.

Atwal, who joined CBO in early June, has yet to adorn much of her office, except for one question written on a message board that states: Who is feeling the pain?

In this segment of the health care industry, it’s not the patients Atwal is focused on healing, but the health care facilities that need revenue to continue providing services to rural communities, she says.

As previously reported in the Journal, hospitals in Washington State suffered $2.1 billion in operating losses in 2022, according to data from the Washington state Hospital Association.

Atwal says rural hospitals often don’t have the qualified staff or resources to provide billing and revenue management services, so those entities turn to CBO, which staffs remote, U.S.-based agents to work on behalf of a facility to collect payment for services from insurance companies and patients.

“It’s a very complicated system and requires a certain level of expertise,” says Atwal. “It can be difficult to hire people who stay on in those roles, and when you’re looking at rural settings, that becomes even more difficult.”

When working with patients, Atwal says, time is of the essence for hospitals to receive payments due.

“The longer (the bill) ages, it is less likely you’ll be able to collect,” she says.

Atwal says she’s looking forward to using her skills and experience to grow the CBO’s market presence, value, and skilled workforce.

“One of the things that attracted me to Inland Imaging is that I can bring in my unique background from everything that I’ve learned being a lawyer, to everything that I’ve been able to do as a business executive and leader in sales and marketing and growth,” she says.

Atwal’s executive and entrepreneurial experience includes roles as owner of Spokane-based Brightway Business Consulting Services LLC; chief operating officer of Spokane Valley-based information technology and cybersecurity company Intrinium Inc.; and director of business development at SAP Concur, a Bellevue, Washington-based software development company.

She says another reason she joined CBO was to work with a team again after spending over a year solo as a business coach and consultant at Brightway.

“I really began to realize that I missed having a team,” Atwal explains.

CBO has 30 employees who work remotely from throughout the Pacific Northwest and Montana. The company has many longtime employees and clients, that Atwal says are a testament to CBO’s company culture.

“We’ve built these working relationships over the years and, paired with hard-to-find staff, hard-to-access expertise, we bring all of that in one partnership to our clients,” she says.

Working with a team again also will allow Atwal to continue offering mentoring opportunities, she says.

“It just all feeds into my DNA … being the eldest of seven girls and from an East Indian immigrant family.”

She says she’s looking forward to capitalizing on CBO’s marketing efforts. 

In the future, the company may consider a rebrand to change the company name from an industry term used by many health care billing companies to one that appeals to industry decision makers.

“If you Google CBO, you’ll find it on other websites or competitors in other places,” explains Atwal.