10 Blunders to Avoid in Cardiology Billing

June 06, 2014

Cardiology is a specialty care and like all non-primary care domains of healthcare it requires billing experts and experienced teams of medical practitioners to complete cardiology-specific billing without errors and losses. While sub-categorization of cardiology services have safeguarded patient interest and improved claims processing by insurance carriers, cardiologists have suffered great financial losses and from process blunders which has attracted medical audits. Interventional cardiology, echo-cardiology, surgery & transplant and general clinical cardiology are some of the subcategories which have specific HSPC, CPT and ICD care and diagnostic codes. With such complex billing, cardiology billers must take precautions to avoid the following blunders –

  1. Not upgrading to EMR
    Although adoption of EMR seems like an apparently costly affair, in long term, effective EMR adoption can not only improve your Medicare reimbursements but improve the cardiology billing process too.
  2. Having isolated front end and technical team for billing
    The result of front end and the technical team working in sync will eliminate the possibility of leaving out some patient data from filing records. For example, if the front end team does not acquire or note down the required data from the patient at the time of walk in, it can cause coding errors and subsequent claims rejections by carriers.
  3. Upgrading coding changes manually
    If you had started introducing all these changes into your billing system manually six months ago, then you would have been in a comfortable position. But at this juncture, with ICD 10 launch coming up in 2015, manual coding upgrading can prove disastrous for your cardiology practice.
  4. Selecting the wrong billing service provider
    With billing demanding medical experts and billing consultants who have knowledge of cardiology sub-categorization, it is of utmost importance to select a medical billing service provider with dedicated team of cardiology consultants.
  5. Selecting the wrong clearing house
    Most clearinghouses have tie ups with selective insurance carriers and you have to judiciously select one which can cater to the claims of majority of your patients without lengthening the process or increasing the cost.
  6. No supervision of RCM reports
    Revenue cycle reports add financial and strategic value to your cardiology practice but many medical practitioners make the blunder of ignoring these RCM reports and manage their revenue streams blindly.
  7. No audit checks in place
    One of the biggest financial and operational risks to your cardiology practice can be an unwarranted audit. It is nothing short of a blunder to not conduct regular audit checks for your practice and avoid any gaps in process as well as service.
  8. Forgetting denied claims
    Most cardiology practices leave 25 - 30% of their revenue unrealized due to rejected claims or underpayments which are never appealed thereafter.
  9. Letting AR age beyond 30 days Allowing accounts receivable to age in your system reduces the chances of collection and payment. ARs exceeding the age of 30 days are nothing short of a billing blunder.
  10. Ignoring payer’s mix
    Lastly, not customizing your billing services as per your payers mix can deplete your profitability in long term. With Medicare inclusions around the corner and insurance carriers becoming stricter with their reimbursement rates for cardiologists; it is imperative to have a balance of government and non-government carriers in your payers mix.

MedicalBillersandCoders.com offers extensive specialty billing solutions with its team of medical experts and cardiology consultants. With us as your billing partners, you can never make a billing blunder or cause harm to your financial health..


Category : Best Billing and Coding Practices