A single cardiology day can produce very different claims. An E/M visit, an in-office echo, a Holter read, a stress test, a device check, and a hospital procedure do not bill the same way, and payers do not treat them the same way.
We manage the billing around the services your practice actually performs.
Authorizations that match the claim
Imaging, nuclear studies, and many procedures need authorization before the service.
The problem is often not a missing authorization. It is an authorization that does not line up with the CPT code, the date of service, the site, or the payer on the claim.
We review whether the authorization matches the billed service, date, site, and payer before submission when that information is available.
Global and technical components
Many cardiology diagnostic services can be billed globally, or split into professional and technical components depending on where the study was done and who owns the equipment.
The claim needs to reflect what your practice actually performed. A small component error repeated across hundreds of studies adds up quickly.
Diagnostic testing and monitoring
ECGs, Holter and event monitoring, echocardiography, stress testing, nuclear imaging, and remote device monitoring each come with their own documentation, frequency, and payer rules.
We pay attention to those rules so recurring services do not quietly fall out of compliance or out of payment.
Procedures and global periods
Procedural work brings global-period rules, modifiers, and follow-up visits that may or may not be separately payable.
We review the surrounding claims so the practice is not leaving payable work unbilled or sending claims that will be denied as bundled.