Outsourcing medical billing is growing in popularity as a method for addressing this remarkable loss of practice income. The range of outsourcing options runs from exceedingly large organizations to individual freelancers working from home to provide medical billing services.



Although the complexity of basic medical billing is quite high, it pales in comparison to the complications that come to play for cardiology billing. Successful navigation of the payers' policies and procedures for paying surgery claims requires specialized knowledge that comes from experience with billing for cardiologists.

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.

A key battle ground in the struggle to collect all of the money due a cardiologist is appealing denied claims and answering extremely specific and technical questions about procedures and diagnoses. Success In this arena requires significant experience, the kind that is only gained from serving many cardiologists for many years.

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.

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.

The safest way for a cardiologist to navigate the medical billing land mines outlined in this article is to travel the medical billing battlefield with a surgical billing service that has deep and proven expertise in traversing the cardio billing hazards. Family doctors should not be performing open heart surgery and generalist medical billing companies should not be providing medical billing services to cardiologists.

Copyright 2008 by Carl Mays II