Payer enrollment for cardiologists has one step most billers miss: the imaging. A cardiologist can be enrolled with every plan and still see office nuclear and CT claims denied, because the imaging side was never set up.
3% of collectionsNo setup feeNo contract
We enroll each cardiologist with Medicare, your state's Medicaid and every commercial plan you take. The list comes from where your patients live, not a default list. Move 20 miles and the payer mix changes, so we check it again.
The group gets its own NPI and enrollment. Each cardiologist enrolls and reassigns benefits to the group. Get that wrong and claims deny, or pay the wrong entity, until it is fixed.
Office echo, nuclear, CT and vascular studies each have a technical side. In most offices it bills under the practice. Some imaging operates as an independent diagnostic testing facility, with its own Medicare enrollment and a supervising physician on file.
Nuclear and CT also need accreditation before the technical side pays. We work out which applies and file it before the first study. See IDTF billing.
Global
Technical side billed by the practice
TC
Own Medicare enrollment, supervising physician on file
CAQH asks for a fresh attestation every 120 days. Medicare asks for revalidation every 5 years, and most plans re-credential every 2 to 3 years.
Every date lives on one calendar: license, DEA, board certification, malpractice and each plan's cycle. We start 90 days before each renewal, so no plan goes dark.
Enrollment starts before the provider's first day. Medicare commonly takes 60 to 90 days, and commercial plans commonly take 90 to 120.
Claims for plans not yet effective get held, not lost. Medicare can backdate up to 30 days, and most commercial plans cannot, so we schedule those patients around the date.
Nothing gets billed under another doctor's NPI. Credentialing is part of the 3%.
We review them by study and by payer, free, with no strings.
3% of collectionsNo setup feeNo contract