Audiologists / Audiology

Customer Situation

With rapidly evolving technologies and complex diagnostic protocols, cardiology billing is best done by experts. Constant advancements in the specialty are leading to complex, ever-changing codes for almost all procedures. In addition to this, the physicians do not have the time to manage billing and coding of cardiology services they deliver.

In cardiology billing, there is always a chance for upcoding or under-coding a procedure. As frequent changes in codes occur in procedures such as iliac repair, angioplasty, stent replacement, ECG recording, etc., cardiology practices lose a large amount of revenue to erroneous billing.

Our experts are certified, trained coders and billers informed with the recent advancements and developments in cardiology billing. They are technically sound and are aware of the complicated MACRA rules. We are capable of identifying and fixing issues in your billing system and increasing revenue.

Our expertise in Cardiology includes but is not limited to:

• Peripheral Studies
• Diagnostic Cardiologic Procedures
• Cardiac-Periphery interventions
• Pediatric Cardiology
• Nuclear Cardiology

CHALLENGES

200,000+ charges were pending to be billed under the HRSA program & other payers
All information regarding the Vaccination should be registered on the NCDHHS (North Carolina Department of Health and Human Services) website, which in coordination with federal, state, and local partners, is responding to the COVID-19 pandemic

Solution

Our team understands the list of codes and suitable modifiers given by CMS for cardiology billing and ensures that we stick to it. We apply different billing processes depending on whether the patient was an inpatient, outpatient, treated on the same day, or another day. Our specialists are aware that cardiac surgery preauthorization is essential to avoid authorization denials. We recommend the following best practices.

• Working with the billing company, we identified the processes for claims submission and created a set of best practices for billing and coding of COVID-19 vaccination and testing claims.
• We recognized that all claims should be submitted to the insurance company and the HRSA uninsured program for self-pay patients through the Practice Management system
• The MBW team was trained on the new billing & coding guidelines of the HRSA program while working from home
• We trained the billers to load the demographic details of all vaccinated patients into a front-end system called Unity