Proven Strategies for Cardiology Billing Challenges and RCM Improvements

Revenue collection for complex cardiology services is a big nightmare for medical billers. You know that a denied medical claim brings more pity for cardiology billing practices. This is so because just to locate the minute error behind the rejected claims, you’ve to repeat the whole process. Most of the time, insurers deny the claims for a multitude of reasons. On the other side, medical billers and coders keep trying hard until they get the payments.

Don’t you think it puts a burden on your revenue cycle? A denied claim must be re-submitted. In other words, we can say:

• It doubles the time and energy invested, and the time for revenue collection increases.
• The time reinvested in a denied claim can be used for other claims.

Overall, a little unconscious mistake or unexpected error costs valuable time and resources. That’s why no cardiology billing company wants a denied claim at all. But things don’t always go as we want them to, especially in cardiology billing. All we can do is indulge in more efforts for RCM improvement and fewer denials.

Therefore, we’re here to introduce some proven strategies for resolving your cardiology billing issues.

Cardiology Billing Challenges: An Obstacle for RCM Improvement Struggles

According to a review report from Becker’s Hospital Review, 80% of all medical bills have errors. Isn’t it shocking? Wait, that is not all. Another finding from NerdWallet reveals that approximately 50% of all Medicare claims are erroneous. That’s so much to digest at once. As cardiology practices are one of the major specialties, they have a large share of these numbers. Therefore, keeping a healthy ratio of claim denials (denials lower than claims accepted) is necessary.

Let’s have a look at common hurdles faced by cardiology medical billing companies in USA.

Payer Complexity Issues

EOB (explanation of benefits) is what every insurer provides to patients insured by any program. With time, healthcare costs fluctuate, and so does the EOB document. The insurers usually inform their clients about it. However, patients did not pay attention to this as much as required. On the other side, hospitals and practices also face difficulty due to fluctuating reimbursement policies. As a result, the impact of it transfers to the financial health of hospitals in the form of denials.

Regulatory Compliance

Since we’re talking about cardiology billing, how could we neglect the federal and state rules? We have many such compliance regulations for medical billing and coding. For instance, HIPAA, Stark, and Anti-Kickback laws, etc. Adhering to all these laws is necessary for any medical billing service. Otherwise, the state and federal governments may charge heavy fines for disobeying the laws.

Complexity of Procedures

It is not hidden how complex the procedures are for cardiovascular and related diseases. Similarly, documentation for filing medical bills is even more challenging. But even if we understand the complexities, a little error in the bill ruins the effort of revenue optimization.

Winning Strategies to Overcome Cardiology Billing Issues

Addressing the challenges in medical billing services is necessary for RCM improvements. Here are some winning strategies for your cardiology practice:

Wise Investment: Upgrade to Advanced Health IT Solutions

We can at least get rid of human errors and reduce the claim processing time with automation. Therefore, we suggest you employ automated software for repetitive cardiology billing tasks. Once you do so, you will see how efficiently you can handle your revenue cycle.

Outsource Cardiology Billing to Experts like P3 Care

Cardiology billing responsibility can be shifted to a qualified third-party vendor. As billing for you is the sole responsibility of these vendors, they never distract. They send you reports and updates with time about the claim status. So, they prove to be a cost-effective solution for timely claim submissions.

Other Proactive Tips for Cardiology Practices

• Educate your teams on effective medical billing services. Inform and train them for changing policies and requirements.
• Use certified EHR technology for cardiology billing tasks.
• Facilitate claim status tracking and e-appeals by using payer portals.
• Follow-up on unpaid claims with effective RCM strategies.

Conclusion

The surge in cardiology costs and heightened regulatory and compliance demands are real problems. Cardiology billing, grapples with an array of obstacles, hampering their RCM. Therefore, we are in dire need of a holistic approach to address all these nuances. We hope the strategies mentioned above will help you boost your cardiology revenue to the max. Above all, we must say that you should pay close attention to outsourcing your medical needs. And if you can’t do so, then at least invest in IT technologies.