Every medical practice, especially a specialty like cardiology, is heavily relied on reimbursements. As patient volume is increasing across the country, the skill shortage is putting pressure on the providers. A crucial practice segment like cardiology, demands for efficient billing and coding process to prevent revenue loss. However, changes within the regulations and claim submission requirements make it difficult for the providers to navigate the complex web of cardiology billing. The stratospheric wages are contributing to this massacre as well.
In this situation, all you need is to implement the best practices within your cardiology billing and coding.
Bad Practices in Cardiology Billing
- Coding based on symptoms: There are instances where your staff implement codes based on the symptoms but not on the diagnosis. For the best possible reimbursement, symptoms codes are only submitted if they are not related to diagnosis. For example, if the patient is diagnosed with angina, you should not code for chest pain.
- Ignoring coverage guidelines: The most common mistake a cardiology healthcare providers make is when they forget to change a specific patient’s healthcare coverage. Verifying one’s eligibility for insurance is not enough. In addition, it’s crucial to consider whether your team has reviewed coverage rules prior to a cardiac operation. The billing staff should confirm that all previous authorizations, referrals, and pre-certifications are in the proper location before scheduling any procedures.
- Not including proper modifiers: Only the codes are not enough. Along with correct diagnosis and procedure codes you must implement appropriate modifiers. Without the accurate modifier you can face claim denials.
- Failing to validate user inputs: In cardiology billing and coding inputs of users are crucial. It ensures accurate and complete information. If your staff is missing out on verifying patient information, it can lead to erroneous billing thus revenue loss.
4 Easy Steps to Upgrade Your Cardiology Billing System
- Analyze the current procedures: You must analyze the current procedures within your practice to identify the gaps with practice standards. You must identify the key performance indicators to understand the status of your practice.
- Continuous education: ICD-10 and CPT codes undergo changes quite frequently. Your staff must stay ahead of these changes. Modifiers are one of the key components in efficient cardiology billing. If there are errors in modifiers you might end up losing your revenue. Therefore, staff education and training are necessary to understand these requirements.
- Coding comorbidities: Comorbidities are relevant health conditions documented by the physicians. Coding comorbidities ensure accurate reimbursements for the providers. For instance, a cardiologist was treating a patient with congestive heart failure. In that case the documentation must show that the physician had to factor the patient’s other health condition like anemia or COPD. Coding these comorbidities lets the payer know the patient’s additional conditions so that payer can estimate the patient’s expected costs.
- Audit frequently: Regular internal audits reveal common coding and documentation errors. It will show areas where staff training is needed. An open communication channel between physician and the billing team is a necessity for successful revenue cycle management.
Sunknowledge Can Assist You
Sunknowledge Services Inc is a healthcare revenue cycle management organization, who can navigate your cardiology billing complexities. The only organization serving both payers and providers at just $7 per hour.
The team of expert medical coders and billers has an extensive knowledge of complex regulations and coding requirements. With the implementation of the latest technology, they can streamline your cardiology billing and coding services.
At Sunknowledge you will have the benefits of:
- 80% reduction of overhead costs
- 99.9% accuracy within claim submission process
- 100% HIPAA compliance
- Consistent monitoring of submitted claims and follow-up
Outsourcing your revenue cycle management is a crucial decision. However, when you can have a reliable partner like Sunknowledge you can sweep off your billing worries. From pre- to post billing their team of expert professionals can handle all your administrative tasks. To understand why they are hailed as the best within the industry, you can contact them today!
Sunknowledge Services Inc. – an ISO 27001:2022 certified, American-owned & operated company, headquartered in New York City – is a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain.
