Cardiology Billing Services

Our certified coders (CPC) and billers (CPB) are experts in navigating the complexities of cardiology medical billing practices. They stay current on coding guidelines and modifiers to ensure accurate claims submissions across a range of cardiology-related services. Our cardiology billing services encompass a wide range of procedures, including ECGs, echocardiograms, stress tests, holter monitoring, and more. We handle everything, from initial coding to claims submission and follow-up, allowing you to focus on patient care. Here are the steps we follow to achieve it:

• Implement cardiology-specific billing software that includes features such as automatic calculation of reimbursement rates and codes for cardiology procedures.
• Leverage billing support systems such as electronic data interchange (EDI), electronic medical records (EMR), electronic health records (EHR), and others to facilitate electronic submission of claims and electronic payment processing.
• Gather comprehensive patient demographics, medical history, and physician referral information, along with complete insurance payer details, including coverage type, prior authorization status, effective date, expiration date, and claims address, to create accurate claims documentation.
• Tackle the entire spectrum of billing models, from value-based care and telemedicine to capitation and episode-of-care billing. 
• Ensure billing workflows are up to date and compliant with AAPC-specified cardiovascular 92920 to 93793 CPT code range, ICD-10 codebook, HCPCS codes, NCCI, and relevant modifiers to capture specific diagnostic tests, evaluation, and management (E/M) service, etc.
• Assign accurate codes for billing and claims submission for various cardiology procedures encompassing diagnostic testing, interventional procedures, electrophysiology (such as polypectomy, EMR, ESD), cardiac rehabilitation, peripheral vascular interventions, angioplasty, implantable cardioverter defibrillator (ICD) placement, pacemaker implantation, cardiac catheterization, etc.
• Stay updated with the diverse payer regulations and fee schedules for Medicare, Medicaid, private insurers like AthenaHealth and Aetna, managed care plans, Tricare, Veterans Health Administration benefits, and employee health coverage. 
• Appoint a dedicated claims status specialist to address patient inquiries and liaise with payers, ensuring timely claims adjudication.
• Receive EOB from payers to verify the claimed services and causes for claims denials. Also, we resolve discrepancies or disputes and proceed to the appeals process if necessary.
• Generate comprehensive reports stating out-of-pocket expenses, deductibles, copayments, and coinsurance for each patient and inform them about their payment responsibilities. This helps our clients prevent unpaid bills, resulting in a revenue boost.