Cardiology is a branch of medicine that is constantly evolving. The growth in technology and diagnostic procedures is the reason that this branch is complex to carry out. The same goes for its billing, coding guidelines, and frequent advancements in cardiology medical billing make the process challenging.
Apart from that, cardiologists are already busy professionals, and taking time out for cardiology medical billing is a hassle. Due to this, healthcare providers prefer to outsource cardiology medical billing services. This not only helps in handling the administrative process but also elevates revenue cycle management.
As the field of cardiology is complex, there is a need for specialized services to tackle challenges such as adjustments in codes, changes in modifiers, and different procedure rules. Cardiology billing services focus on keeping up with trends and providing custom services for the unique needs of cardiologists.
The scope of medical billing is wide and there are numerous factors to it. As a result, there is a need for a proactive approach to maximize revenue and streamline the workflow of operations.
In this blog, we will understand the basics of cardiology medical billing to improve the performance of the practice.
Key Focus Areas of Cardiology Billing
Knowing and understanding the core of cardiology medical billing can be extremely helpful in solving the issues of billing. This helps in leading a financially successful practice where operational and revenue management is under complete control.
Let’s go through all the major contributors to the sound financial health of a cardiology practice.
Understanding The Coding System of Cardiology
Two types of codes are common in cardiology medical billing. They are CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) codes. Where CPT codes are for identifying the services provided, ICD-10 Codes are diagnosis codes that track the health conditions of patients to improve the quality of data.
CPT codes are organized based on the type of service such as surgical, medical, or diagnostic aid. The branch of cardiology has a multitude of codes. These codes are allocated to services rendered to carry out the process of medical billing further.
Some examples of CPT codes in cardiology practice are:
93000 – Electrocardiogram, routine ECG with at least 12 leads
93306 – Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording
CPT codes are regularly updated by The American Medical Association (AMA). The updates are done yearly, and they reflect technological advancements and other medical changes. This highlights the need for billers and coders to stay updated on changes. This is essential to avoid errors in coding and delays in reimbursement. Accurate coding leads to accurate billing and adequate revenue.
When it comes to cardiology, the coding system is vital to enhancing the performance of the revenue cycle. Here, the coders must specialize in Coding along with professional certification such as CCC (Certified Cardiology Coder) certification by AAPC (American Academy of Professional Coders).
Verification of Patient’s Insurance Coverage
Verification is an unmissable part of cardiology medical billing and is essential to establish a patient’s financial responsibility. This is necessary not only for the patient but also for healthcare practice. The studies show that verification of insurance coverage prevents patients from financial stress and promotes care-seeking behaviors.
In the case of healthcare providers, verification helps prevent payment delays and claim denials. The cause of Denied claims is the refusal to bill by insurance companies. Whereas delays happen due to the long duration to process claims.
The consequences of both denials and delays are revenue leakage and disrupted workflow.
There are numerous benefits to understanding verification and cardiology medical billing services offer these benefits to healthcare practices. It helps cardiologists stay current with the latest insurance policies and requirements. It eases communication with patients and establishes trust to elevate the patient’s experience. On the other hand, healthcare providers improve their administrative processes.
Documentation for Proper Claims Filing
Proper documentation is a prerequisite for successful cardiology medical billing. It helps in ensuring the accuracy of major aspects of billing which in turn is responsible for achieving adequate revenue. Correct documentation is to attribute correct diagnosis and treatment codes. As a result, the cardiology practice can earn proper revenue. It helps in avoiding errors in coding that lead to denials and delays in claims. Hence, perfect documentation leads to clean claims and a faster billing cycle.
Apart from this accurate documentation allows the healthcare practice to continue with patient care. Documented data such as medical history helps in acquiring information regarding a patient’s health conditions. Further, it helps in deciding a treatment plan and improving outcomes.
While documenting, one thing to keep in mind is the need to comply with regulatory requirements. All the information must be recorded according to compliance measures and guidelines. This is essential to protect healthcare practices from fines and legal consequences.
Timely Submission of Claims
All other aspects of cardiology billing are pointless without the timely submission of claims. It is vital not just to receive revenue but also to ensure quality care for patients. The mark of an efficient medical billing system is a practice free from denials and delays. As the complexity of cardiology medical billing is constantly increasing, it gets even more important to focus on the timely submission of claims.
Upon fulfilling this requirement, cardiologists can ensure reimbursement and can also avoid legal penalties for non-fulfillment. Healthcare providers must keep in mind that insurance companies outline specific dates for the submission of claims. Missing these due dates can lead to claim denials and rejections.
This explains that the submission of claims is a priority for achieving the desired medical compensation and cardiologists must maintain promptness in fulfilling the same.
Staying Current with the Latest Changes
Cardiology medical billing is difficult but what adds to this complexity is changing regulatory guidelines. Staying current is a necessity for accurate billing and reimbursement.
First and foremost, a cardiology practice can be a financial success only with proper coding for different procedures and treatments. Coding is one such area that experiences frequent changes and it is helpful to cardiologists to know these changes. Using the latest version of coding manuals can derive optimum results and growth in the revenue cycle.
Secondly, there are compliance requirements such as HIPAA (Health Insurance Portability and Accountability Act), CMS (Centers for Medicare and Medicaid Services) guidelines, and ACA (Affordable Care Act). Being informed about changes according to these guidelines and staying informed is vital for the financial growth of the practice. Such regulatory guidelines define the various requirements such as the safety of patient information.
Outsource Professional Cardiology Medical Billing Services
Outsourcing a cardiology billing company can be the best option to eliminate the hassle of administrative functions. However, the advantages are not limited to this, professional cardiology billing services ensure preciseness at every step of medical billing.
Medical billing services are well-versed in the specificity of coding. With a team of professionals, they make sure that information is translated into accurate codes. Their assistance at every step is to ensure timely submission and prevent claim denials and rejections.
Apart from that, there is a focus on developing and maintaining denial management and follow-up procedures. All in all, cardiology billing services help in improving the overall performance to achieve adequate reimbursement with a streamlined flow of operations.
Conclusion
Cardiology medical billing is a challenge for healthcare providers and leveraging medical billing services to handle is a great option for cardiologists. Deciding to choose outsourcing is followed by a decision to choose a suitable billing partner.
If you are a cardiologist looking for medical billing services, then your search is over with Unify Healthcare Services.
Unify Healthcare Services is a leading medical billing company in USA, well-equipped in cardiology billing practices. They have a team of expert billers and coders who offer custom-made cardiology billing services to every client. With Unify, you can take your cardiology practice to the next level of financial success, maximum revenue, and productive workflow.
