Tuesday, January 20, 2009

Cardiologists Need Cardiology Billing Experts in Their Corner

By Carl Mays II

Medical practices lose money every single day (often over 20 percent of their realizable income) because they are not utilizing medical billing specialists, technologies, processes and management that can compete with insurance companies.

Medical billing outsourcing is a growing trend that medical practices and facilities are employing to level the playing field with insurance companies. Potential outsourcing options start with individual medical billers working from their home to medical billing services that with thousands of providers.

Medical billing is a highly complex area and it requires experience-based knowledge and expertise to contend with insurance companies. When it comes to cardio billing, the situation gets even more complex. Such complexity can be handled only by a company that is staffed with well trained cardiac billing professionals. The medical billing specialist must be familiar with the specific codes and rules that make up the world of cardiology billing.

As the cost of providing cardiovascular related healthcare services continues to rise, medical institutions and cardiology practices cannot afford to leave revenue uncollected by billing companies or freelancers that are not knowledgeable in cardiovascular billing. It is also important to keep in mind some companies may promote themselves as large cardiology billing service providers but in reality they sub-contract the cardiac billing to freelancers who work from home. Hiring such companies will lead to lost revenue because of the lack of proper process, controls, and training.

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.

The cardiology-driven difficulties of medical billing encompass patient billing also. A cardiologist's patient balance process is more challenging because most of the balances are quite sizeable. Coupling this with the difficulties of explaining to a patient their complicated Explanation Of Benefits and the cardiovascular terminology on their bills drives the need for patient collection specialists that have a strong expertise in cardiac billing. If patients are not handles with care then cardiologists will see their patient collections fall and their patient complains rise - not a good combination.

To avoid all these billing related pitfalls cardiologists need to utilize specialized cardiovascular billing services. It is not advisable for an internist to perform heart surgery, similarly someone without training in surgical coding and surgical billing is not qualified to offer reliable billing services for cardiologists.

Copyright 2008 by Carl Mays II - 16069

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