The Necessity of Experience & Expertise in Cardiology Billing

Over the years cardiology has branched out into an impressive array of sub-specialties – general clinical cardiology, interventional cardiology, echo-cardiology, nuclear cardiology specialty, heart failure, transplant and cardiology surgery to name a few. Within each of these sub-specialties, cardiologists are often called upon to carry out clinically critical and highly expensive diagnostic and preventive cardiology services. While cardiologists have been not been averse to engage themselves in such services, underpayments from insurance carriers have unbearably common.

Even as cardiologists may feel aggrieved, Medicare, Medicaid, and private insurers cite coding and billing inaccuracies as the reasons for denial, delay, or underpayments. And, it may even be true – much like consistent progression in cardiology diagnosis and preventive procedures, Centre for Medicare/Medicaid Services (CMS) too has constantly been evolving cardiology coding and billing standards. It is highly possible that cardiologists’ internal or external medical billing resources could not measure up radical coding and billing changes, leaving revenues being affected. It is significant note that underpayments may have been as large as 20 percent of their realizable income.

Now that cardiologists have realized the importance of replacing their existing cardiology medical billing with more experienced and competent  medical billing specialists, technologies, processes and management that can effectively measure up evolving cardiology medical billing standards, they could be drawn into making an apt choice from several alternatives – independent cardiology billing specialists, remotely operating cardiology billing professionals, and cardiology medical companies or consortiums. Although cardiologists are independent to make a choice that best supports their individualistic needs, medical billing companies often seem to be equipped with cardiology billing specialists knowledgeable in the complex rules utilized by insurance companies to judge cardiologists’ medical claims. The reasons on which the choice medical billing companies are their ability to:

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  • Appeal denied claims and answering extremely specific and technical questions about procedures and diagnoses. It should be remembered that such competence can only be expected from medical billing companies, who often possess significant experience, gained from serving many cardiologists over the years.
  • Cover a wide range of cardiovascular billing, track underpayments, and devise remedial action in conformity with multiple procedure rules and complicated contractual adjustments. It may also be possible to expect medical billing companies to be prepared for complicated requirements of reporting and insurance follow-up required in billing for cardiovascular practices.
  • And, reconcile the balance in relation to explanation of benefits (EOBs). It is significant medical billing companies are more adept at convincing patients of the responsibility to compensate for medical bills which may sometimes be more than what the insurer is liable to pay up as part of explanation of benefits (EOBs).

Thus, it is advisable that cardiologists – who themselves are vastly experienced and competent to undertake critical cardiology services – source their medical coding and billing services from Medical Billing Companies that have evolved with cardiology coding and billing benchmarks. has always been the first to recognize and deploy medical billing resources that are dynamic enough to overcome any coding, billing, and procedural complexity. With access to such responsive resource-base spread across the 50 states in the U.S. it is finitely possible that cardiologists will be able to figure out causes for underpayments, aggressively follow-up, and realize their cardiology bills fully.