How To Reduce Errors From Cardiology Billing & Coding Services?
Dealing with repeated claim denials and rejections is a whole frustration in cardiology medical billing services. Receiving claim denial reports and notifications is enough to make a bad day for any healthcare practitioner.
If your medical billing staff isn’t efficient enough to file and submit medical claims on time then you’ll never be able to collect revenue rightfully for your business. Therefore, never compromise on your medical billing team and get connected with a professional cardiology medical billing company.
As it is implied that a medical practice only keeps growing and doesn’t have time to look back at the claim denials. According to the Medical Group Management Association (MGMA), 65% of claim denials are never followed up and nobody requests an appeal for reimbursements. This uncollected balance exceeds 5-10% revenue of an average-sized practice.
Therefore, cardiologists should take serious actions to prevent revenue loss and ensure consistent growth of their healthcare practice.
Here’s how cardiologists can make a well-functioning plan for claim denial management and streamlined medical billing services.
Pain Points Of Cardiology Medical Billing Services and Possible Solutions
There are four major causes of claim denials in a cardiology practice;
- Insufficient or inaccurate documentation.
- Constantly changing insurance payer rules and guidelines.
- Ever-changing cardiology codification structure and how insurers recognize them.
- Complex payment methods are often not understood by patients.
Therefore, healthcare practices should be dynamic and proactive towards these points to smoothly carry out medical billing and coding tasks.
Inaccurate Or Insufficient Documentation
While most of the challenges are largely introduced by governmental or regulatory institutes and insurance companies, documentation is particularly controlled within the practice.
You can rely on your EHR/EMR system only if you’ve entered accurate information in the database. Being a cardiologist, you work in a specialty practice so you might also work with referring providers that may or may not have provided accurate documentation as well.
A recent JAMA Network Article and Study established that only 38.5% of system reviews and 53% of physical examination entries reconciled with the actual information of patient-physician encounters.
Therefore, it stands for reason that healthcare providers should deploy reliable solutions for documentation. Because this documentation is entirely translated into medical codes as it is, which are further used to prepare and submit medical bills.
If medical bills are down-coded due to missing or misstated information then it could lead to excessive claim denials and revenue loss.
Solution:
Addressing documentation issues should be a paramount consideration for struggling cardiologists. They should partner with professional cardiology billing and coding specialists who can guide them on how to streamline their entire healthcare revenue cycle management services.
There are some medical billing companies like CureCloudMD in the USA which also offer EHR/EMR management outsourcing services. You can acquire these services to virtually manage your documentation. In this way, a dedicated team can invest enough time to collect and review your documentation. It will also reduce claim denials and corresponding rework but also increase revenue by accurately reflecting your services to insurance companies.
Apply Accurate Billable Cardiology Medical Codes
The most integral challenge for cardiology coding specialists is to stay updated with the ever-changing guidelines of cardiology diagnosis and procedural codes. Therefore, cardiologists should make sure that the medical coding team is well-versed in the annual updates, additions, and exclusions to the CPT, ICD and HCPCs codes.
However, the cardiology billing team should also ensure that the updated medical codes are applied according to the requirements of different insurance companies.
A medical code used for a cardiology procedure or test at one carrier may be improper when submitting medical bills to another carrier because it could lead you to miss out on the depth of detail required by each insurer.
Solution:
If you’re running a busy practice then its better to extend your medical billing team by partnering with an outsourcing cardiology billing company. It is a cost-effective yet efficient solution to execute your medical billing and coding tasks without any hassle.
Not only your office staff will get proper guidance for healthcare revenue cycle management but also you can enjoy the freedom to spend more time with your patients.
Ever-Evolving Insurance Payer Policies
When it comes to payer-specific guidelines for medical bills then it not only includes coding-specific changes but also each healthcare insurance company has company-exclusive policies regarding medical bills.
These policies also keep evolving throughout the year and every size of cardiology practice is obliged to comply with the updates in their requirements as guided. For most healthcare practices, it is quite overwhelming to stay current with these changes, to say the least.
Did you know? There are almost 900 health insurance companies in the USA and even if not all of them are operating in your area, there’s a good chance that as a specialty practitioner, you may have contracts with many insurance companies with seemingly countless coverage plans and groups.
Therefore, if not 900 then you must at least stay updated with the billing requirements of at least 10-25 different insurance carriers. It adds to your work stress and makes it difficult for you to leverage your reimbursements to your fullest potential.
Solution:
To stay compliant with your insurers and all payers smartly, you can rely on a reliable outsourcing cardiology billing company. For example, CureCloudMD is a US-based medical billing company that offers dedicated account managers complimenting their outsourcing cardiology billing services.
These account managers are responsible to make sure that your payments are collected on time efficiently. Their medical billing team doesn’t leave your medical claims unattended after submitting them to insurance companies instead they constantly follow up with all the payers for adjudication.
They make sure that your medical bills are entirely prepared and submitted according to your insurance payer’s requirements. They also provide regular reports which contain data on your medical bills, claim denials, and payment posting.
With these intuitive reports, a cardiologist can easily understand the payment behavior of every patient and the insurance company. It also helps healthcare providers to make well-informed business decisions based on real-time insights.
Conclusion:
Claim denials/rejections are the major red flags for the financial health of any medical practice. Therefore, cardiologists should ponder the reasons that are causing revenue loss due to medical billing and coding issues. It helps them identify, monitor and eliminate frustrations from cardiology billing and coding services. However, partnering with a reliable cardiology billing company is one of the most cutting-edge medical billing solutions that can help cardiologists to stay ahead of billing and payment problems.
Did you know? 77% of healthcare practitioners tend to outsource medical billing services in the USA. If you’re also thinking to partner with a cardiology billing company then here is the checklist that can help you find the best-in-class medical billing company in the USA;
An outsourcing medical billing company with the following traits is the go-to choice for wise healthcare practitioners;
- HIPAA-compliance.
- Transparency.
- ISO certification.
- Extensive experience in your specialty billing.
Want us to make your job easier? CureCloudMD is a HIPAA-compliant medical billing company that offers a complete range of healthcare revenue cycle management outsourcing services along with medical credentialing, account receivable (AR) recovery services, claim denial management services and medical billing audit services.
Schedule a free demo of our cardiology billing services for better business growth.
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Affan Sabir has an experience of more than a decade in providing revenue cycle management services to well reputed hospitals, labs & healthcare professionals.
A track record for helping clients improve their revenues drastically has made the author first choice for medical practitioners seeking to reduce their accounts receivables and get the best returns for their hard work from insurance companies.