In 2015, the American Hearts Association reported that nearly 800,000 Americans are affected by heart strokes annually. Further, given the lifestyle changes and the aging population, heart disease remains the leading cause of death in the US, and accounts for 1 in every 4 deaths. This is thus a high number for medical care providers to manage in tandem with resources invested in providing advanced treatments and scientific research for newer treatments.
In the backend of all this is the complex billing process and the claims submission. Cardiology billing becomes very crucial considering the volumes and processes involved.
Cardiology billing involves key process like capturing patient demography, appointments scheduling, insurance verification, coding, payment and claims management, collections, account receivables and reconciliation. The coding complexity brought in by the ICD-10 system and changing rules & regulations that cardiologists need to keep up with the newer treatments and innovations, often leads to inaccurate coding which can shrink revenue profit margins.
In-house billing teams are stated to leave at least 20 percent of the revenue uncollected! Additionally, the replacement of the fee for service by value based performance has also made it difficult for cardiologists to comply with these complex business and clinical demands.
The secret lies in the specialized cardiovascular billing services. Only an experienced cardiac billing expert, preferably an outsourced billing service, can offer the medical knowledge and coding expertise that can help navigate insurance company billing procedures, or like the need for separate coding for therapeutic and diagnostic procedures; or which Cardiology-specific CPT codes cannot be used with a single specific modifier; or where non-congenital procedures are to be used as a single code, etc.
Today, more than 70 percent of medical practices are outsourcing their denial and AR follow up tasks. Outsourcing these tedious and complex activities has been gaining popularity ever than before as these billing service providers are experts in this area and their only objective.
So it is in the interest of any medical practices, especially among cardiologists, to continue to keep outsourced their medical billing and claims process to be more efficient in the new MACRA programs and quality reporting audits.Back