Cardiology billing for office and hospital work
Cardiology practices manage office visits, imaging, procedures and device monitoring across different settings. We check documentation, component billing and payer requirements before submission, then follow denied and underpaid claims.
- ImagingComponent billing review
- 50+Specialties covered
- DevicesMonitoring interval checks
Where cardiology claims need closer review
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- Review services during the global period
A postoperative service may be included in the surgical payment. Check the procedure, global period and documentation before billing a separate visit or applying a modifier.
- Device checks billed at the wrong interval
Device-monitoring codes have service and reporting requirements. Match the device, monitoring period, recorded work and payer policy before creating a charge.
- Echo components split incorrectly
For imaging, confirm which component the practice furnished and whether the code permits separate professional or technical billing. The report, location and equipment arrangement must support the claim.
What we bill for Cardiology practices
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How Cardiology accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- Build the procedure and payer worklist
Group office visits, imaging, catheterization and device-monitoring claims so each can be reviewed against the appropriate documentation and payer requirements.
- Charges checked against the note
For an imaging claim, compare the order, performed study and signed interpretation with the billed services. Query missing or conflicting documentation before submission.
- Eligibility and authorization ahead of the visit
For a planned test or procedure, check coverage, network status and any authorization requirements. Record approved dates and services; authorization alone does not guarantee payment.
- Review the payer response with the clinical record
Separate missing information, bundling edits, coverage decisions and potential underpayments. Record the evidence needed for a correction or appeal and track the filing deadline.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for Cardiology practices
- Coders who work cardiology daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
Cardiology billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate Cardiology service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat Cardiology practices ask
Do you handle both the hospital and office side?
Yes. Professional billing for the physician and the office based work are handled together, which matters because the professional and technical split depends on where the study was done.
Our echo volume is high. Can you keep up?
Volume is the easier part. Tell us your monthly study count during the audit and we will tell you plainly what staffing that needs.
Can you work our aged cardiology A/R?
Yes, and we separate what is still inside filing windows from what is not before anyone spends time on it.
What if we use a specific cardiology module?
We agree access to the cardiology module, procedure reports and billing queues during setup. Your practice retains control of user permissions.
Check the policy for the date of service
Coverage and coding requirements depend on the service, setting and payer. These primary sources support a claim review; they do not replace the clinical record.
CMS procedure-to-procedure edits and CMS NCCI frequently asked questions.
Have a cardiology coder read your last ninety days
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.