Top Revenue Leaking Cardiology Billing Errors You Should Avoid

Billing errors are the biggest contributor to revenue loss for cardiology practices, followed by inefficient accounts receivable operations.

Research papers suggest practices lose about 8% to 15% of their revenue each year due to inaccurate cardiology billing processes. Revenue loss of this magnitude during times of staff shortages, rising payroll costs, and shrinking profit margins make healthcare delivery unsustainable.

As a result of this, reports of US healthcare organizations closing down every month have become quite common.

Therefore, if you are a cardiologist or someone in charge of revenue cycle functions – do your best to avoid the cardiology billing errors we will discuss in this article.

Let’s start.

1) Inaccurate insurance & eligibility verification

Insurance and eligibility verification is the step where the provider verifies coverage and eligibility benefits of the patient. Not verifying the details accurately can result in revenue loss or underpayment by the insurance company.

2) Missing information:

Industry reports suggest that missing information results in about 24% of all claim denials. These errors are unacceptable and can be easily avoided. To ensure there is no missing information, cardiology billing teams should audit claims before submitting them.

3) Incorrect documentation:

There is no doubt that medical documentation requirements by payers are burdensome, time-consuming, and complex. A major chunk of the denied claims can be avoided by ensuring zero documentation errors on submitted claims.

4) Coding mistakes:

Certain cardiology procedures need to be bundled together, while others need to be unbundled. And so it is vital that medical billing and coding teams are aware of these coding guidelines. Not making these cardiology coding mistakes can reduce billing errors and save practices a lot of money every year.

Every year, healthcare organizations lose billions of dollars because of improper medical billing operations. And the magnitude of loss varies based on the medical specialty, and types of procedures performed.

For example, a study by the Journal of the American College of Cardiology found that about 5.7% of the percutaneous coronary intervention procedures had billing errors that resulted in a payment difference of $1,000 per claim. And so avoiding such errors can save cardiology practices a significant amount of revenue each year.

To learn more about what steps or processes you should implement to avoid these errors, or to get our tried and tested cardiology billing best practices, please contact Sunknowledge Services Inc., a HIPAA-compliant healthcare revenue cycle management organization serving US healthcare providers and payers since 2007.