3% of collections. Flat. All 50 states.matt@onlycardiologybilling.com  ·  Mon to Fri, 9 to 5 Central
Every denial, worked and reported

Cardiology denial management: worked, not parked

Cardiology denial management starts with the five denials every cardiology practice sees. Most have a pattern, and the pattern has a fix. We appeal the claim in front of us and fix the cause behind it.

Talk to our teamExplore pricing

3% of collectionsNo setup feeNo contract

Cardiology denial management: a biller marking a denied line on a remittance
78452Nuclear stress · appealed with the notePaid
Every denial gets a cause, then a fix
01The five

The five denials every cardiology practice sees

  • Nuclear stressA diagnosis the plan's policy does not cover, or a covered one listed behind it on the claim.
  • Office visitsA plan pays every 99214 as a 99213, and nobody compares the note.
  • MonitorsA two-week monitor billed with a Holter code, or the wrong duration.
  • Records requestsA Medicare Advantage plan asks for the note months later, and nobody answers.
  • Prior authApproved, then denied, because the auth number never made the claim.

Each one has a cause we can name. See how nuclear stress claims should go out.

Each one has a cause
Denials this monthBy reason
  • 78452Diagnosis not coveredAppealed
  • 99214Paid as 99213Appealed
  • MonitorWrong duration codeCorrected
  • RecordsMedicare Advantage requestAnswered
  • AuthNumber missing from claimCorrected
  • Every denialCause named
One month of denials, by reason
02Within days

Worked within days, not months

Every denial gets reviewed within days of the remittance by your biller, not at month end.

The review names the cause. If it is ours, we fix it and resend.

If it is in the documentation, we tell the reading physician what was missing, so the next note has it. Appeals use only what the record already shows.

Worked, not parked
Claim 10533Nuclear stress 78452 · POS 11
  1. DeniedMedical necessity
  2. ReviewedThe note supports the study
  3. AppealedWith the note and prior test
  4. Paid78452, global
A denial, worked to paid
03Appeals

Appeals with the right documentation

A denial gets appealed with the record the payer asked for, not a form letter. For a nuclear stress, that means the ordering note, the prior test results and the policy section.

For a downcoded visit, the appeal is the note. Recoupments get contested with the full record, inside the plan's deadline.

Not a form letter
Appeal · Claim 10533Nuclear stress · POS 11
  • Ordering note with symptoms
  • Prior test results
  • The policy section cited
AppealSent
Remittance · Claim 10533After appeal
78452Nuclear stress, globalPaid
What the payer asked for, and what came back
04On the report

What you see on the monthly report

Denials by payer, by study and by reason, with how many were appealed and overturned. One plan denying every nuclear stress shows up as one line. We stop appealing one at a time and fix the source.

Your denial rate sits next to the cardiology target every month. Appeals are part of the 3%.

Cardiology billing reports
One line per pattern
Denials · SeptemberBy payer
Plan AEvery nuclear stress

78452

Diagnosis order fixed on every claim

PatternStopped
Plan BEvery level 4 visit

99214

Paid as 99213 and appealed with the note

PatternAppealed
One line per pattern
05Get in touch

Send us your last 90 days of claims

We review them by study and by payer, free, with no strings.

Talk to our teamExplore pricing

3% of collectionsNo setup feeNo contract

Free, no strings
Your 90-day denial reviewLast 90 days
  • Denials, by payerIncluded
  • Denials, by reasonIncluded
  • Which ones can still be appealedIncluded