Cardiovascular medicine is complicated, so it’s no surprise that cardiology billing is also complicated. Complex procedures, changing regulations and a rising volume of patients drive home the need for accurate and timely claims approvals and payments.
Keep reading as we dive into some of the billing challenges cardiovascular practices face and why an RCM partner can help.
The challenges of cardiovascular billing
Cardiologists specialize in arguably the most important part of the body: the heart. As we all know, the heart keeps blood pumping throughout our body via blood vessels. To diagnose and treat cardiac-related issues, a wide variety of services and procedures are offered, thereby complicating the billing process. Here are some of the top billing obstacles they face:
- Complex procedures. Cardiology covers a wide spectrum of services, from stress tests and echocardiograms to cardiac catheterizations and pacemaker insertions. Each procedure comes with its own set of codes, modifiers, and documentation requirements. Missing even a minor detail can result in delayed payments or claim denials.
- Changing regulations. The medical billing landscape changes fast. Cardiology sees frequent updates from the Center of Medicare and Medicaid Services, payers, and specialty societies. New CPT and ICD-10 codes, changing coverage determinations, and evolving quality measures all increase the risk of noncompliance and lost revenue.
- Compliance and audit risks. Cardiology is one of the specialties most scrutinized by payers and regulators. Documentation must be thorough and support the level of service billed. Inaccurate or up coded claims can lead to audits, penalties, and reputational damage.
The benefits of a specialized RCM partner
In the United States, heart disease is the leading cause of death for all genders and races. It’s clear that we need cardiologists and we need them to be able to dedicate their attention and expertise toward patients. Here are some of the leading benefits to outsourcing your practice’s billing to an RCM partner:
- Deep knowledge of cardiovascular billing requirements. Unlike general medical billing services, a team that specializes in cardiology RCM understands the nuances of the specialty and challenges, as noted above. From patient registration to denial management, they bring expertise that ensures claims are submitted correctly the first time—reducing rework and speeding up payments.
- Improved financial performance. When there are fewer claim denials and faster payments, you’re able to enjoy higher collections and reduced accounts receivable. All of this leads to improved financials for your practice.
- Less administrative stress. When you outsource your medical billing, you can reduce the administrative stress your employees experience. This gives your team more time to focus on patient care and practice growth.
Choosing the right RCM partner
If you’re ready to outsource your billing practices or are searching for a new partner, we have two resources to help you make the right choice for your practice and patients:
- How to select the right RCM partner for your medical practice, complete with an evaluation form to compare your options.
- Considering an offshore vs. U.S. based billing partner, with a focus on what’s best for patient data security.
Want to chat with us to see if we’d be a good fit? We’d love to connect.
