3 Reasons to Tackle EKG Over-Read Billing with Outsourcing

Authored by: Morris Moran

It is no surprise that COVID-19 has heavily impacted high-risk cardiac patients. In fact, a previous Mount Sinai study conducted by Dr. Anuradha Lala-Trindade, MD, showed that heart failure patients hospitalized with COVID are at triple the risk of intubation and nearly twice as likely to die compared to people without the pre-existing heart disease. Even so, hospitals in hard-hit places, including Florida, Louisiana and Tennessee, have had to delay or reschedule tests, procedures and surgeries that are considered elective and nonurgent.

A Jacksonville, Florida cardiologist who typically performed stress tests, EKGs and other cardiac maintenance for 25 to 30 patients per day saw his patient volume drop to 7 to 10 per day during the peak of COVID. At the same time, EKG interpretation volume plummeted 50 to 60%.

As a result, the practice reduce its clerical staff by more than half. When patient volume picked back up, rehiring staff became a big challenge. Qualified candidates had either found other positions or opted out of the workforce with help from the CARES Act.

Though government assistance kept many providers afloat, it did not cover all revenue lost due to staffing issues and volume fluctuations. As a result, coding and billing fell behind, causing a backlog of EKG interpretations and reimbursements.

Outsourcing to Tackle Fluctuations

Cardiology practices have had to analyze new approaches to manage the unpredictable billing volumes of the last year. One approach is to outsource EKG interpretations to a partner. While only a subset of the overall billing function, outsourcing offers important benefits:

  • Improves reimbursement rates since EKG over-reads are often last in the stack of bills but represent opportunities to boost revenue.
  • Frees up internal teams who don’t have time to wade through volumes of EKG correspondence.
  • Saves cost compared to paying internal staff, so practices are paid more than the cost to over-read EKGs.

Among the many benefits of outsourcing EKG billing, peace of mind is priceless. Your team can focus on high-dollar claims while an outsourcing partner manages the EKGs in the background. Obtaining reimbursements for EKG reviews can be tedious due to the large number of claims and small payments per claim.

First Coast Billing Group interfaces directly with hospital databases, allowing our team of professionals to submit claims in bulk on behalf of cardiologists. More than 300 providers in Florida trust FCBG for their EKG billing. To learn more about our services and technology, visit https://firstcoastbillinggroup.com/ekg.