Achieving Better Reimbursements in Cardiology Billing

The industry revenue of Cardiology practices has grown at a CAGR of 2.3% in the past five years. In this fast-paced world of practice, Cardiology billing can often be a time-consuming process. Being one of the more complex specialties, practitioners and staff juggle between delivering quality care and answering to administrative responsibilities. As the sector switched from cost to a value-based fee schedule, the billing issues have expanded to financial statements. To sustain the functional and financial stability of your practice, you must consider a strategic approach in your billing and coding services. Learning more about the common mistakes and the best practices can help you achieve accurate reimbursements for rendered services.

Common Errors in Cardiology Billing

  1. Lack of insurance verification: Evaluating coverage benefits is crucial for ensuring accurate reimbursements. The payment process can be compromised if the patient’s insurance coverage is not verified before a procedure. If the service rendered is not covered by the insurance, it may lead to unpaid reimbursements, jeopardizing the financial stability of your practice.
  2. Insufficient documentation: Usually, Cardiology patients suffer from more than one health complication, like hypertension and diabetes. These are known as comorbidities. If you do not document the additional complications, you will not get reimbursement for the rendered services regarding the same.
  3. Inaccurate coding: Just like other services, an accurate coding process is necessary for efficient Cardiology billing. Even after maintaining proper ICD-10 and CPT codes, you might miss the modifiers. Also, the place of service codes are required which are often missed due to the lack of knowledge of your staff. Furthermore, documentation of a code that understates or overstates the condition of the patient – what is otherwise known as undercoding or overcoding – can lead to financial and legal consequences. Ultimately, the patient will lose confidence in your practice and there could be potential revenue loss.

How to Improve Your Cardiology Billing Practice

Even a minor mistake in Cardiology billing can lead to a potential revenue loss. This is a major concern for providers across the country. If you have an in-house billing staff, you must implement constant training and education to stay updated about the coding and billing guidelines. Also, you must consider the integration of the following practices to enhance the billing process in Cardiology-

  • Meticulous insurance verification
  • Accurate documentation (from patient’s personal information to medical history)
  • Maintaining precision in diagnosis, procedure, and comorbidity coding
  • Focusing on accurate modifier codes
  • Integration of comprehensive technology to automate the process
  • Staying updated with the changing coding guidelines and billing requirements of different payers

To implement these strategies within your practice, you need to invest time and money in your in-house staff’s training and education. The Cardiology realm is already burdened with high patient volume and workload. And there is a constant shortage of skilled workforce. In this situation, hiring and sustaining an in-house team is a daunting task that can hamper the quality of care. To eliminate these billing woes, most providers are turning to outsourced medical billing and coding services.

The Sunknowledge Excellence

We lead in the realm of medical billing and coding services in terms of efficient and cost-effective revenue cycle management. Our knowledgeable billers and coders can analyze your current system to identify the gaps within the process and instill comprehensive industry practices as per your needs. For more than a decade, with great references, we have worked with some of the largest practices within the country.

Along with cutting-edge technology and 100% HIPAA compliance, we can reduce your overhead expenses by up to 80% almost immediately. At industry-competitive pricing, we can deliver you an end-to-end solution for your Cardiology billing in the long run.

To implement a comprehensive strategic approach in your medical billing and coding practices and optimize reimbursements for your services, we invite you to connect with our experts for a no-obligation consultation.