Cardiology Billing Services
Diagnostic testing, device checks and cath lab claims, billed by people who know why an echo gets bundled.
Cardiology is billed in three places at once: the office, the hospital and the diagnostic suite. Each one pays differently for the same doctor. Our cardiology billing services keep the professional and technical components apart. We apply modifier 26 and TC where they belong. We also track global periods on device implants, so a follow-up is not written off as included when it should have been paid.
If you are comparing cardiology medical billing services, ask three questions. How does the biller handle echo and stress test bundling? How do they handle remote device monitoring intervals? And what documentation does a payer want before it pays for an ICD? Those three answers tell you more about your collection rate than any headline percentage.
Cardiology medical billing services that get the claim right the first time
Why Cardiology Billing Is Hard
Heart patients often face large out-of-pocket costs. Insurers price strictly against the policy, so one small mistake on a claim turns into a denial or a long delay. The patient is left with a balance, and the practice is left with unpaid work.
Our cardiology medical billing services are built to stop that at the claim, not after it.
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Coding and documentation help for your staff
We teach as we go. Your team gets clear coding guidance and help improving clinical documentation. The aim is simple: capture every procedure and every diagnosis properly the first time. That is what keeps our clean claim rate above 95%.
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Finding where your revenue leaks
We use analytics to find where your billing is leaking. Our cardiology billing team looks for the patterns: codes that keep getting denied, work that is never billed, payments that come in under contract. Then we fix the cause.
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Full revenue cycle work at a fair price
Our cardiology EHR billing service is thorough and still affordable. It is built to get you paid more, and paid sooner.
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A fast process with no double entry
Time matters in cardiology. Our process is quick and it is accurate, and it does not ask your staff to do the same job twice.
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Keeping up with LCDs and payer policy
Cardiology billing rules change often. We track Local Coverage Determinations, coding updates and payer policy, so your claims follow the rules that apply today.
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A billing team you can actually reach
Our cardiology billing specialists are easy to reach when you have a question. We work as a partner, not a supplier, which means keeping you in the loop rather than waiting to be asked.
Components, bundling and the device clock
Cardiology is billed in three different settings for the same physician, and the errors cluster around who owned the equipment and what was already included.
Professional and technical
Most diagnostic tests split into a professional component, which is the interpretation and report, and a technical component, which is the equipment and the staff. Where the practice owns the equipment and reads the study, the global service is billed. Where the study is done in a hospital and the cardiologist only reads it, the professional component is billed on its own with its modifier.
Getting this wrong is usually a setup error rather than a coding decision, which means it repeats on every claim until somebody finds it. A practice being paid roughly a quarter of what it expected for echoes is almost always billing the wrong component.
What is already inside the study
A stress echocardiogram includes the stress test and the imaging. Billing the components separately is a bundling error. The same applies to several nuclear studies and to the tracings that accompany a procedure. Check the current edits rather than relying on memory, because these pairs change.
Remote monitoring runs on a calendar
Remote monitoring of pacemakers, defibrillators and loop recorders is payable per monitoring period, not per download. Bill it more often than the interval allows and the extra denies. Bill it less often and the revenue is simply never claimed, which is far more common.
The record has to show the review happened and what it concluded. An automatic report with no physician review behind it does not support the professional component.
Device implants and the global period
An implant carries a global period, and routine wound checks inside it are included. Device checks are a separate service with their own schedule and are not part of the surgical package. Practices write off both because it is easier than separating them, and give away the second.
Cardiology Credentialing and Hospital Privileges
Cardiology credentialing has two halves. Most practices finish only one. The first half is normal payer enrollment: CAQH, Medicare through PECOS, Medicaid and the commercial panels. The half that gets missed is hospital privileges. Each hospital medical staff office grants these on its own timetable. You need them before any inpatient consult, cath lab case or call coverage. Privileging is not credentialing. It does not run on the payer clock, and it has to start earlier than most groups expect.
The second gap is in-office diagnostic testing. Echo, stress testing, nuclear cardiology and vascular studies often need you to enroll as an Independent Diagnostic Testing Facility. At the very least, the payer has to accept your supervision and equipment set-up. Bill the technical component without that enrollment and the claims deny. They deny cleanly, months after you bought the machine.
We run payer enrollment, privileging paperwork and IDTF enrollment as one project. See our medical credentialing services.