In cardiology medical billing, the expectation is to achieve steady revenue cycle management. Only a proactive approach can streamline the administrative tasks and lead to positive results.
Handling the complexity of medical billing and coding is all about getting familiar with frequent inaccuracies and taking corrective actions. This task calls for cardiology medical billing expertise with knowledge of changing trends.
However, the need to be proficient is the reason behind healthcare provider's stress. Leading the way becomes difficult without the right direction and often results in revenue leakage.
Understanding the burden of cardiologists, this blog acts as a guide with all the vital tips that can improve the workflow and enhance the revenue. We will explore the common medical billing mistakes with ways to correct them.
Common Inaccuracies in Cardiology Medical Billing and Coding
The difficulty in cardiology as a specialty makes its medical billing and coding intricate. Further, these complexities prevent healthcare providers from attaining adequate reimbursement. That is why understanding the core of intricacies becomes vital to navigate through them efficiently.
Here are some common mistakes that are preventing healthcare providers from uplifting their revenue cycle:
Inadequate Insurance Coverage Verification
A patient’s insurance coverage specifies various details of whether that patient is eligible for cardiology treatment under the policy. It is the responsibility of healthcare providers to verify these guidelines before rendering medical services.
Negligence in checking the insurance coverage can have adverse effects leading to unpaid claims. Moreover, verification is not limited to insurance eligibility, it is vital to attain prior authorizations, pre-certifications, and referrals.
Every patient is unique with different insurance coverage guidelines, and this emphasizes the need to check it thoroughly. Only after completing this step, healthcare providers must move to providing medical services.
Limited Understanding of Comorbidities
Another factor that adds to the intricacy of cardiology medical billing is comorbidities. Time and again, cardiology patients receive multiple diagnoses (heart disease may be due to diabetes, hypertension, and COPD) known as comorbidities.
In medical billing and coding, recording all possible issues becomes essential for effective claim filing. When healthcare providers fail to translate comorbidities into actual codes, the revenue cycle suffers.
A limited understanding of comorbidities prevents healthcare providers from accurate translation into ICD-10-CM combination codes.
To counter this, healthcare providers must check all coding guidelines for all the combination codes. Classification of multiple diagnoses can be hard for healthcare providers, which is why they can rely on medical billing services.
Missing Proper Modifiers
Other than codes, modifiers are a part of cardiology medical billing. The two-digit modifiers are added to the CPT codes bringing attention to other medical procedures or services.
For Illustration:
One of the well-known ‘Modifier 25’ is added to highlight significant and separate evaluation and management (E/M) together with another procedure on the same day. The modifier is added at the end of the CPT code.
Missing the modifier while claim filing is not advisable to healthcare providers. Healthcare providers must realize the importance of modifiers and ensure their usage in cardiology medical billing and coding.
Cardiologists must pay attention to the following modifiers:
- 22 – Increased Procedural Services
- 51 – Multiple Procedures are Done at the Same Time
- 52 – Reduced Services
- 53 – Discontinued Procedure
Overall Coding Mistakes
Precise coding is the essence of avoiding denials and achieving adequate revenue. Being specific in coding and maintaining absolute accuracy is crucial to filing clean claims.
On the other hand, healthcare providers must code for symptoms rather than just sticking to diagnosis codes.
The maximum number of denials happen due to coding errors and healthcare providers must focus on improving that. Only then can they maximize their revenue and enhance the operational flow.
Now that we know the common mistakes, let’s understand ways to improve revenue cycle management.
Tips To Improve Cardiology Medical Billing
All healthcare providers are striving for improvement in their administrative management.
With these tips, healthcare providers can streamline their workflow reducing the scope of claim denials and rejections.
Accurate Documentation
Maintaining accuracy while documenting patient data can prevent errors in cardiology medical billing. For this, healthcare providers need to document data such as patient medical history, diagnoses, treatments, procedures, and comorbidities.
On the road to denial-free healthcare practice, thorough documentation is the key to achieving success.
Thorough Eligibility Check
Insurance eligibility checks can aid the healthcare provider in boosting revenue cycle management along with a perfect claim submission process. As a result, healthcare providers need to take insurance eligibility seriously.
Elimination of Manual Errors
In cardiology medical billing, manual errors can disrupt the flow of administrative tasks and result in instability. Healthcare providers must find ways to eliminate the human error element in medical billing and coding.
They can partner with cardiology billing services and work with experts to eradicate manual errors and lead to revenue success.
Proper Medical Coding
Healthcare providers can successfully improve their medical billing with proper medical coding. Cardiologists must stay specific to their specialty and use appropriate codes while claims filing.
Choose Eminence RCM as Your Cardiology Medical Billing Partner
Navigating the cardiology medical billing landscape is all about precision at every medical billing and coding step. Medical billing services can take over administrative tasks and find solutions to complex medical intricacies effortlessly. That is why healthcare providers can trust cardiology billing services to boost their bottom line.
Choose Eminence RCM as your cardiology medical billing partner and witness a positive change in your revenue cycle management.
Eminence RCM is a prominent medical billing company in USA providing tailor-made medical billing services for various specialties. We work with a dedicated team of coders and billers well-versed in cardiology medical billing. Our team takes every measure to ensure complete HIPAA compliance, error-free documentation, clean claims, and reduced denials.
With our professional experience, you can streamline your revenue cycle management and optimize your operational flow.
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