7 Reasons To Outsource Cardiology Billing for Medicare and Medicaid
Cardiology is one of the toughest specialties for medical billers. And it becomes overwhelming when you add the complexities of Medicare and Medicaid. Demanding regulations, intricate coding, and a gigantic pile of claims make the entire operation nothing less than an administrative overload.
In this challenging scenario, you can really benefit from outsourcing cardiology billing. Of course, you are going to have to do the hard job of finding a reliable billing partner. But rest assured, they will keep your cardiology billing fully compliant with Medicare and Medicaid regulations.
Why Is Cardiology Billing So Complex For Medicare And Medicaid?
Cardiology billing under Medicaid and Medicare can be extra challenging due to many reasons like complex regulations and extensive reimbursement requirements. Common challenges include the following:
- Intricate coding: When it comes to cardiology billing, expect your coders’ job to get tough. This is because cardiology coding involves detailed ICD-10 and CPT codes along with a wide array of modifiers. Every nuanced difference in the service changes the code. For instance, the code for diagnostic catheterization is different from that of therapeutic catheterization.
- Prior authorizations: You may need to get prior authorizations from Medicare and Medicaid for a lot of cardiology procedures. The result of this extra step is in the form of an added administrative burden.
- Bundled Services: It can sometimes become difficult to distinguish between services that can be bundled and the ones that need to be billed separately. A minor inattentiveness to detail in this regard can lead to underpayments and even denials.
- Changing Regulations: Not keeping up with regulatory changes can affect the payout. That is why it is essential for the billing team to engage in ongoing monitoring and training.
- Lower Rates of Reimbursements with Medicaid: Medicaid plans often yield lower reimbursements. This makes billing accuracy and efficiency crucial for maintaining a better overall profit margin.
Top Reasons To Outsource Cardiology Billing For Medicare And Medicaid
As mentioned above, outsourcing medical billing refers to delegating this task to a billing company. As a result, that company becomes a revenue management wing of your practice. This is because not only do they manage your billing, but they also take care of your entire cash flow.
The key benefits of outsourcing your cardiology billing include the following:
Billing experts have the knowledge and skills to comply with Medicare and Medicaid requirements. They go with accurate documentation and precise coding to keep claim denials at the lowest level.
With reduced claim denials comes maximized revenue. It is as simple as it gets. When you have fewer denials, you experience fewer disruptions in cash flow. As a result, your bottom line improves.
Cardiology billing outsourcing can reduce A/R time on claims by many days. Clearinghouses use their specialized workforce to follow up on claims in order to speed up reimbursements.
Medical billing companies have dedicated team members to take care of your cardiology RCM. Additionally, almost all of them use AI and automation during the process. This mix of human expertise and machine intelligence makes the billing process more efficient and fruitful.
Perhaps one of the greatest benefits of outsourcing cardiology billing is improved compliance. Billing companies tend to be well-versed in Medicare and Medicaid regulations. They are less likely to make claim errors that may lead to denials and audits.
A very logical outcome of outsourcing cardiology RCM is a decreased burden on your practice. As a result, you and your team can focus on patient care in a better way.
Outsourcing cardiology billing does cost money. But that will be a much reduced expenditure compared to running the RCM operations in-house. You won’t have to spend a lot of money on hiring human resources, buying systems, and allocating a space in the office. All you will need is to select a package that suits your budget and requirements; that’s all.
How Outsourcing Improves Cardiology Revenue Cycle Management (RCM)?
When you outsource cardiology billing to clearinghouses, you essentially delegate the billing, coding, and compliance work to experts. This makes your operations less erroneous and more speedy. And this directly improves your bottom line.
Another way outsourcing helps your cardiology practice is that it allows you to focus more on patient care. Also, you get extra room to bring in strategic improvements to your operations. As a result, your finances improve further.
What To Look For When Choosing An Outsourcing Partner?
It is undoubtedly beneficial to outsource cardiology billing when you are overburdened with administrative work. But it is imperative that you hand over this work only to a qualified and reliable billing partner. This is why you should look for the following features in a company you are about to hire:
- Expertise in cardiology billing: This one is crucial. Look for a billing company with years of proven work experience, particularly for Medicare and Medicaid. Check online reviews and testimonials to confirm they are experienced and legit.
- Technology integration: Look for a company that uses the latest billing tech. Ask about the software solution they use. Also ask about the level of automation and machine learning they bring to the process.
- Security compliance: When hiring a billing partner, inquire about their approach to complying with HIPAA regulations for data security.
- Reporting: Ask the prospective company about the means they use for reporting. Today, most companies use interactive dashboards to display real-time progress. These dashboards are better than the reports sent electronically or through mail.
Conclusion
Outsourcing cardiology billing for Medicaid and Medicare offers a lot of strategic benefits. It reduces administrative burden, streamlines cash flow, and helps improve patient care. However, it is essential that you choose a qualified billing partner to reap all the benefits.
At AltuMED, we offer comprehensive cardiology billing services to help your practice grow. We rely on a highly skilled team and the latest tech to bring you great results. For details, contact us today.
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