Advances made in cardiology in recent years have increased the success of treatment but have also resulted in new and more complex medical coding and billing requirements.
Because cardiology is a relatively high-cost medical field, practices stand to lose large amounts of revenue from billing and coding errors. The complexity of the ever-changing codes means that there may be errors, so it is extremely important to have a coding and billing team that is experienced in cardiology. That way they can minimize errors and efficiently handle rejected and denied claims, unlike less experienced office staff, who are likely to end up spending several hours sorting out each claim, and may not figure out the more complicated coding issues in the required time, resulting in unpaid claims and significant revenue losses.
Challenges Associated with Cardiology Billing
Complications start with scheduling:
The medical billing process starts in the scheduling phase when insurance coverage and payer requirements have to be confirmed. Even details such as whether the appointment happened in an in-patient, out-patient or emergency room/urgent care setting must be correctly coded or the claim will be denied.
High-dollar claims result in huge losses:
In a family medicine practice, hundreds of patients may be seen daily, resulting in a huge number of low-dollar claims being filed, but in cardiology, examinations and treatments are more in-depth and time-consuming, so far fewer patients are seen each day. If a physician sees 10 or 15 people on a normal day, the loss of revenue for a single unpaid claim can be the loss of up to 10% of the day’s income.
Complicated procedures and treatments involve complex coding:
Modifiers are an important part of coding. These additional subcategories of numerical codes are required to give the details that are required in order to be reimbursed for all services delivered. While inexperienced coders can look up the general code for a procedure, they often do not know how many levels of modifiers they need to include or all the numerically-coded details that need to be added. Payers are trending towards more bundling of costs into single codes, which can simplify billing—but coders must recognize any variance from the standard bundled items and know how to itemize to avoid over- and under-coding.
Outsourcing Billing and Coding to
Medcare MSO Increases Revenue
With cardiology billing getting more complicated all the time and payers and medical institutions forever looking to cut their costs, an effective revenue cycle management (RCM) system is becoming increasingly more necessary. Outsourcing billing and coding to Medcare MSO allows medical professionals to focus on patients, because experienced, certified specialists are handling their RCM from start to finish.
Medcare MSO’s services begin with scheduling and cover all aspects of billing, up through debt collection when necessary. Our certified coders are experienced in over 40 specializations, including cardiology. Our billers know how to recognize red flags for over-coding and under-coding and make sure clean claims are submitted.
Because we focus only on coding and billing, we are able to stay up to date on government offers and can maximize revenue from government incentives. We handle daily billing, respond to denials and rejections swiftly, and even manage charting and coding compliance, annual payer adjustments and pay back, as needed.
Medcare MSO’s proprietary software is an integral part of our innovative services. We are extremely successful at increasing our clients’ income and reducing wasted time due to billing errors. Get a free demo today to see how we can free up your staff while increasing your bottom line.