Medical billers and medical billing services are the financial backbone of a medical practice. Practices that do not have the right medical billing expertise in their corner can easily lose more than 20 percent of their practice's potential revenue.

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.

As the cost of providing cardiovascular related healthcare services continues to rise, medical institutions and cardiology practices cannot afford to leave revenue uncollected by billing companies or freelancers that are not knowledgeable in cardiovascular billing. It is also important to keep in mind some companies may promote themselves as large cardiology billing service providers but in reality they sub-contract the cardiac billing to freelancers who work from home. Hiring such companies will lead to lost revenue because of the lack of proper process, controls, and training.

Deep familiarity and comfort with cardiology procedures and terminology does not come from serving one or two cardiologists. Cardiac billing success requires both broad and deep expertise in order to collect all of the money owed the cardiologist and successfully appeal claims which have been denied or answer questions the payers may have about a claim.

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.

It is not only insurance billing that is more complicated for cardiologists; patient billing is also more difficult. The patients often have high balances, complicated explanations from their payers and do not understand all of the invoices they are receiving from their cardiologist. A billing company that has strong cardiology billing experience has spoken with patient about such statements many times before. A less skilled patient collection effort could leave the cardiologists with less money and unhappy patients.

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