Cardiologists Need A Specialist When It Comes to Billing
Medical billing is a critical service that supports healthcare providers by submitting claims and collecting payments from insurance companies and patients. Medical billing specialists need to be experts to guarantee that the bills are in full and in a speedy manner. It is quite common for over 20% of a practice’s collectable revenue to remain unclaimed because of improper coding and ineffective collection tactics.
Outsourcing medical billing is growing in popularity as a method for addressing this remarkable loss of practice income. The range of outsourcing options runs from exceedingly large organizations to individual freelancers working from home to provide medical billing services.
In thinking through the billing options available, it is essential to understand that medical billing is complicated and requires deep expertise and expansive experience. When a specialty is involved, such as cardiology billing, the requirements for success become even harder to realize. Success requires that the medical billing company have a team that is knowledgeable in the complex rules utilized by insurance companies to judge cardiologists’ medical claims.
The choice of an experience billing provider has become all the more important for cardiologists as they watch their cost rocket upwards. With their margins shrinking they must be confident that their medical billing service is collecting every dollar the cardiologist is owed. Selecting the proper medical billing service is made all the more difficult by the fact that many companies claiming to be experts in billing for cardiovascular practices actually do not do the billing themselves, but outsource the work to other vendors that are based in India or work from their homes.
Deep familiarity and comfort with cardiology procedures and terminology does not come from serving one or two cardiologists. Cardiac billing success requires both broad and deep expertise in order to collect all of the money owed the cardiologist and successfully appeal claims which have been denied or answer questions the payers may have about a claim.
A company that does not encompass a wide range of cardiovascular billing experience will find it difficult to track underpayments since multiple procedure rules and cardiovascular procedures have significantly more complicated contractual adjustments than a typical family doctor or internist’s claims. In addition, the billing software and system design of a generalist billing company will often be insufficient for the more complicated requirements of reporting and insurance follow-up required in billing for cardiovascular practices.
It is not only insurance billing that is more complicated for cardiologists; patient billing is also more difficult. The patients often have high balances, complicated explanations from their payers and do not understand all of the invoices they are receiving from their cardiologist. A billing company that has strong cardiology billing experience has spoken with patient about such statements many times before. A less skilled patient collection effort could leave the cardiologists with less money and unhappy patients.
The safest way for a cardiologist to navigate the medical billing land mines outlined in this article is to travel the medical billing battlefield with a surgical billing service that has deep and proven expertise in traversing the cardio billing hazards. Family doctors should not be performing open heart surgery and generalist medical billing companies should not be providing medical billing services to cardiologists.
Copyright 2008 by Carl Mays II