From financial issues created due to Affordable Care Act to hardships related to health IT implementation, cardiology practices in the US are facing various business challenges.

Will 2014 bring respite from payment issues for cardiologists?

The Medicare Physician Fee Schedule 2013 has had a -2% impact on cardiovascular medicine coupled with 26.5% cut from the SGR formula and 2% cut related with Budget Control Act of 2011’s sequestration provisions. This pushed cardiology practices to absorb the new rules quickly in order to get payment for cardiovascular services.

However, in 2014, as per the rule finalizing policies and payment rates issued by CMS, changes not related to SGR result in a 1% increase for services offered by cardiologists. They will also get more opportunities for using registries to participate in Physician Quality Reporting System program. It has also been proposed by the CMS that payment for device-intensive cardiovascular services will be done on a bundled basis rather than paying for each individual APC (ambulatory payment classification) code; however, this will be implemented from 2015.

Issues related to implementation of health IT

Cardiology practices may have made some progress in terms of patient care and safety but health IT issues have been difficult to overcome. Work pressure has increased due to healthcare reforms and in order to derive the required benefits from EMR and health IT systems, practices are being forced to integrate clinical decision support in the workflow. This is being done to improve decision-making at the point of patient care but lack of time is posing hindrance in implementing it successfully.

Meaningful use requirements

Due to lack of preparation, some cardiology practices are also facing difficulties in attesting to meaningful use stage 2 under which they will have to meet the requirements for exchanging patients’ health information electronically with other providers. 2014 is the last year in which cardiology practices who haven’t participated in MU can do so if they want to avoid penalties starting from 2015.

With the Affordable Care Act, many insurance companies have made drastic changes, causing trouble for patients as well as practices. Lack of certified support staff, coders and billers and high costs of retaining the existing staff has also turned into a challenge for cardiology practices.

Benefits of seeking help from a medical billing company-
The pressure of meeting government regulations, private payer requirements and challenges of running the business on a daily basis is forcing cardiology practices to seek help from a billing company. This is helping them eliminate the headache of claim filing, denial management, HIPAA compliance, coding, billing, and follow-ups with insurance companies, along with implementation of health IT and various other tasks.

Specialized Medical Billing Services such as have been helping cardiologists sail through business challenges for over a decade. MBC has the largest consortium of certified billers and coders who make use of the latest technology to ensure maximum reimbursements and minimum claim denials. Our team handles all details related to cardiology medical billing with precision, leaving your sufficient time to concentrate on qualitative patient care.

Published By - Medical Billers and Coders
Published Date - Apr-01-2014 Back

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