Irrespective of the specialty or practice size, all medical billers need to be familiar with the medical billing codes and guidelines. However, cardiovascular billing is much more complex and requires highly specialized skills and in-depth knowledge which only comes with training and experience.

Cardiology Practice Case Study

Case Study on how MedConverge assisted a cardiology practice in reducing accounts receivables by $80,000 within four months.

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The evolving healthcare environment, not just in terms of medical advancements, but also changes in medical coding and billing regulations have led to significant fee reductions in cardiology. On one hand, the average Medicare fee has increased by 1.1%; on the other, Medicare fees for cardiology have declined by nearly 2% year-on-year.

Changes in the treatment of in-office imaging, follow-up on implanted devices and external devices including new codes for interrogation and reprogramming of ICM and ICD devices, billing specifics such as checking medical necessity verification, selective and non-selective catheterization coding, component coding, etc., require highly skilled billing expertise and efficiency.

At MedConverge, we specialize in cardiovascular billing; cardiology, both invasive and non-invasive. We recognize the impact of CPT code changes, ICD-10 and industry regulations. Our coders are not only of Certified Professional Coders (CPC’s) but also Certified Cardiology Coders (CCC’s); and are also AAPC and/or AHIMA certified. Our senior team members have almost a decade of experience in CCC coding.

Our cardiology billers have a thorough understanding of all the key aspects guiding cardiovascular coding. We recognize the complexities of the benefits and the pitfalls of modifiers and how they apply to different cardiovascular services or procedures.

The MedConverge Advantage:

  1. Our coders reassess all key sources of documentation including primary hospital inpatient, outpatient, proficient physician, and clinically trained midlevel staff medical records; over the progressing 12-month period to know the severity of a disease and allocate the most suitable diagnostic codes; to ensure that the highest and most accurate hierarchical condition categories are assigned to patients.
  2. Our medical coders understand, code, and bill straight from working reports that include electrophysiology, interventional and peripheral vascular procedures.
  3. With our experience, we understand that volumes peak as MAOs approach a Risk Adjustment Processing System deadline that is why MedConverge’s workflow process keeps track of volumes to evade over peaking of volumes at the time of deadlines.
  4. Our account managers work with our clients to maintain strong relationships with healthcare providers.
  5. We educate, guide and provide constant feedback to healthcare providers on possibility of documentation gaps and the diagnostic codes that are critical to risk adjustment.
  6. We work with healthcare providers to develop standardized information request processes.
  7. We maintain all coding standards and we add notes and maintain a track of all documents we have used to achieve at a particular CCC category.

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