Cardiology Billing Services: Specialists for a Specialist

September 18, 2008 | By Carl Mays II In Medical Business |

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.

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 typical shortcoming with medical billing services that do not specialize in cardiology billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most cardiologists about 10% of their potential income. If a medical billing company does not understand the multi procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.

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.

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.

About the Author:

Carl Mays II works with, Cardiology Billing Partners is a specialized medical billing service that focuses 100% on cardiovascular billing. Do not select a medical billing service until you have spoken to Cardiology Billing Partners and learned about the benefits of specialized medical billing services.