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presentation

Cardiologists Handle New Regulations and Coding Changes in 2013 with Efficient Medical Billing

May 23, 2013



Cardiologists are likely to face an entirely new scenario with respect to regulations and coding in the upcoming future. With healthcare industry implementing constant reforms and the government as well as private insurers subscribing to increasingly efficient methods of medical billing and claim filing, cardiologists can’t afford to lag behind. In addition to providing quality care to patients, Cardiologists are expected to follow regulations norms and update their billing practices as per new coding guidelines.
Some of the imminent changes in 2013, which can affect billing and collections, are –

  • New updates in CPS and HCPCS Level II codes, Place-of-service coding errors
  • Noncompliance with Assignment rules and Excessive billing of beneficiaries to be penalized
  • Inappropriate payments in 2010 by Medicare to be appropriated in 2013
  • Questionable billing in electro-diagnostic testing to be introduced
  • Part B payments for Glycated Hemoglobin A1C tests to be updated
  • Claims processing errors to be corrected with regards to the Medicare payments for Part B claims with G Modifiers
  • Use of Modifiers during Global Surgery Period to be evaluated and managed

In addition to these regulatory changes, there will be reduction in reimbursements and payouts to Cardiologists for office testing and medical services. This would mean financial turmoil for many Cardiology practices that are not maintaining efficient billing practices. With reduced government support, Cardiologists will have to manage their revenue cycles more carefully in order to remain financially viable. Thus following billing practices could be adopted by Cardiologists for better productivity and efficiency –

  • Updating your billing system with coding changes at a regular interval. CPS and HCPCS coding changes can be readily monitored by keeping in touch with medical publications and coding manuals
  • Educating your staff regarding regulatory changes and the expected impact of the same on your billing and collection practices
  • Checking with insurance provider for pre-authorization and medical coverage details at the registration stage itself, in order to avoid claim denial later on
  • Managing claim filing process and revenue cycle as per the requirements of insurers and reimbursing bodies
  • Monitoring outgoing information and incoming requests or notifications from insurers regarding claim settlement, disputes, document requirements and regulatory changes
  • Install a denial management system in place to track the reasons and trends in denied claims
  • Resubmit corrected claims or file appeal for denied claims with in a turnaround time of 48 hours or less. Ensure review of medical codes, document requirements and grounds of appeal before taking any action
  • Streamlining revenue and accounts to absorb the penalties and costs incurred by audit actions
  • Adhere to all regulations pertaining to laboratory tests and electro-diagnostic tests. With decreased reimbursements and specific guidelines for conducting tests, even a minute oversight can prove to be expensive for your practice

Medicalbillersandcoders.com has been serving varied specialists including Cardiologists across all 50 US States for over a decade now. Our billing and coding experts can help you in handling new regulations and coding changes by creating an efficient medical billing system for you. We provide meticulous attention to detail and dedicated adherence to regulation and codes for billing practices. Our group of experts handle every detail, allowing you and your cardiology practice to focus on qualitative patient care.

 

Category : Outsource Medical Billing