Billing companies that work cardiology claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
Cardiology billing goes wrong in the same few places, and none of them are exotic. The office visit and the test happen on the same day, so every echo, EKG or stress study rides with an E/M that needs modifier 25 and a note that justifies it. Nuclear studies carry a technical and a professional split, an isotope supply code, and a drug line that has to match what was actually drawn up and wasted. If your charge entry person treats these as one lump, the claim denies as bundled and nobody finds out for two months.
Then there are the procedures. A diagnostic cath that turns into a stent is one claim with the wrong code order if someone codes it in the order it happened. Device implants, ablations and cardioversions each carry their own global period, and a follow-up visit billed inside it gets paid once and recouped later. Remote monitoring of pacemakers and loop recorders is a recurring revenue line that practices under-bill, because nobody owns the monthly reading and the time documentation. Prior authorization hits advanced imaging and some nuclear work hardest, usually through a benefit manager the payer hired, with its own portal and its own idea of medical necessity.
Payer mix drives this specialty. Medicare and Medicare Advantage carry a large share of the panel, and the Advantage plans each deny a little differently. A good cardiology biller reads denials by plan and by code, watches in-office imaging rules, and calls on AR that has aged past ninety days. Outsourcing makes sense when your coder is also your referral coordinator, when imaging revenue is slipping and you cannot say why, or when you are adding a second office. Tell bidders your imaging and procedure volume, your payer mix, and what your denial reports look like today.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals