Cardiology practices often meet daunting challenges on their way to success. And the way they encounter them all reflects the dedication and hard work of their team. A cardiology practice doesn’t consist of only expert cardiologists; rather, we have many brains behind us. They handle the back-office tasks for the cardiology practice. From appointment scheduling to claim generation, they do it all for a smooth workflow. However, medical billing services in USA are now outsourced, and that’s the trend today. The US strongly believes in letting people do what they are experts in. So, instead of imposing cardiology billing duties on cardiologists, it’s better to outsource.
Today’s blog truly targets the 2023 RCM trends. The cardiology billing services in USA need to evolve with time for their bright future. The outsource medical billing services put extra effort into their billing tasks. At the same time, they help their practices thrive in the healthcare industry.
Do you know, when the practice owners plan to gear up for the year ahead, what’s top of their mind? What makes them so worried? And what can help them cover each milestone in their journey safely? The only answer to all such queries is in their ‘Revenue’. Losing or not generating sufficient revenue simply indicates poor financial health. Thereby, a practice may be badly affected if it happens. Well, at this point, we have the latest RCM trends, guaranteeing the bright future of your practices.
Devolve down to explore 2023 RCM trends, shaping cardiology billing services in USA.
The Influence of the 2023 Medicare Physician Fee Schedule
Undoubtedly, all stakeholders are waiting for the final 2024 Medicare Physician Fee Schedule. They have kept an eye on the CMS proceedings, as they can significantly impact medical billing services. Anyhow, CMS has made available its final 2023 Medicare Physician Fee Schedule rule.
Reduction in Conversion Factor
The American College of Cardiology has carefully reviewed this rule. Among all others, the suggestions for the drop in conversion factor (CF) are very concerning. It led to a fall in CF from $34.6062 to $33.0775 on January 1, 2023. So, cardiology billing services in USA will earn less revenue in 2023 than in 2022 using this CF.
Performance-based Risk for ACOs
Another point of concern is the performance-based risk assessment in the CMS’s plan for 2023. If you haven’t given serious notice to this point, then it’s not good for your practice. Anyhow, according to CMS, participating in a one-sided shared savings model may be an option. Only those ACOs with limited performance-based risk expertise can benefit from this option. As a result, doctors have more time to adapt to changing circumstances. Eventually, it may have an impact on their medical billing services and cash flow.
Telehealth’s Ongoing Influence
In the past, a giant problematic situation occurred when patients hesitated to visit clinics. Clearly, it was due to the widespread pandemic COVID-19. So, healthcare providers are left with no option than visiting patients door to door. The idea was good but practically it is not applicable for large populations. Instead, reaching the patient online via telehealth services proved very helpful. While this offered a lifeline, it also had drawbacks in comparison to meetings in person.
CMS is thinking about keeping certain temporary PHE codes for telemedicine. It will be beneficial for those who have integrated it into their cardiology practice. According to the ACA, these numbers may continue to be used for telehealth services. We will categorize them as Category 3 codes in cardiology billing services in USA at least through 2023’s end. They could even be given official telehealth service approval permanently.
Navigating Coding Changes
Changes in coding and compliance will also affect your cardiology practice. New guidelines and instructions about reimbursement and compliance are coming soon, according to MedLearn. Cases of improperly coded cardiac catheterization or peripheral operations are still a problem.
Your staff employees who handle coding could benefit from attending seminars or getting updated training. It will help them remain on top of things. The use of Category III codes, updated Congenital Catheterization codes and directives, and specialized cardiac codes for lower extremity lithotripsy are particularly essential in this regard.
To manage the 2023 CPT/HCPCS code changes, think about consulting with coding professionals. This will help to ensure that your staff can effectively utilize the proper codes and follow current guidelines.
Keeping a Watchful Eye on Trends
Companies handling cardiology billing services in USA have a slew of new information to keep track of in 2023. It might take a full-time job just to stay current on the planned changes from the CMS. Your RCM will be impacted by other issues, such as modifications to cardiac coding. Use the most recent version of the RCM software in your company. It’s time to upgrade to specialized RCM alternatives.
