Many cardiology practices across the US are continuing to struggle with the regulatory changes, declining reimbursements, and increasing healthcare costs. It is becoming difficult for them to run a profitable business in an unstable environment.
According to industry experts, small and medium practices will have to start monitoring and focusing on their revenue cycle to identify loopholes and implement changes for improvement. From lowering overhead costs and maximizing revenue to improving patient engagement and complying with reforms, cardiologists will be required to handle every aspect of their practice in order to survive.
Cardiology practices will have to focus on various procedures including coding, billing, and follow-ups with insurance companies. By avoiding errors in these procedures, cardiology practices can easily increase their earnings.
Claims submission and follow-ups
Claim filing procedures are different for different insurers. Even the payout mix with documentation and pre-authorization procedures varies. Therefore, it is important to have a team of billers who are updated with the procedures and guidelines for billing by different insurance companies including, Medicare and Medicaid
Coding change update
Cardiologists will need experienced and skilled coders who are aware of the changes in procedures and codes for this medical specialty. If they are not updated with coding changes, claims will be submitted with errors, resulting in malpractice claims and Medicare audits
Monitoring claim denial
Providers will have to overcome the common reasons for claim denials if they don’t want to spend $25 to $30 on reworking every single denied claim. They will have to ensure that all diagnoses are being coded to the highest level of specificity, claims are being submitted as per the deadline specified by the payers and no duplicate medical claims are being sent for processing
EHR Implementation
Cardiology practices will have to implement an EHR for streamlining various processes. Automated processes can help practices save time on data entry and filing. EHR can also be integrated with telehealth software for saving time and money
Training front-desk staff
It is necessary to train the front-desk staff in entering correct information of patients during appointment scheduling. It has been reported that if they fail to enter accurate information, insurance department staff members end up spending time correcting the errors
Auditing
Cardiology practices need to conduct regular auditing in order to strengthen the medical billing procedure. This will help them reduce errors in the billing process, bringing in more revenue. It will also prepare the practice for an actual audit
Considering the rise in billing and coding complexities, many cardiology practices have started outsourcing their billing requirements to a third party. By availing the services of billing companies such as MedicalBillersandCoders.com, they have been able to enjoy improved revenue and more time for quality care.
Companies like Medical Billers and Coders have a team of certified and experienced billers and coders who make use of their expertise to bring in more payment for providers. They not only handle error-free claims submission and conduct follow-ups but also ensure compliance to HIPAA and other reforms.
FAQs
1. Why is cardiology billing so complex?
Cardiology billing is complex due to diverse specialties, frequent updates to codes, and the need for accurate modifiers. Proper training is essential to stay compliant.
2. How can outsourcing cardiology billing help my practice?
Outsourcing helps ensure timely, accurate claims submission, reduces errors, and improves cash flow. It allows cardiologists to focus on patient care and practice growth.
3. How do I prevent claim denials in my cardiology practice?
To avoid denials, ensure all diagnoses are coded accurately, follow payer deadlines, and submit claims with correct documentation. Regular monitoring can help.
4. What role does EHR play in cardiology billing?
EHR systems streamline cardiology billing processes, reduce data entry errors, and integrate with telehealth, saving time and money for practices.
5. Why is auditing important for cardiology billing?
Regular auditing helps identify errors in billing, ensures compliance, and maximizes revenue. It also prepares the practice for potential audits, avoiding costly mistakes.
