Sources checked: . Sources and review scope.
Cardiology billing services in Virginia need to account for Cardinal Care Medicaid, commercial coverage, and Original Medicare claims under Palmetto GBA jurisdiction JM. We bill cardiology only, from Texas, at 3% of collections.
3% of collectionsNo setup feeNo contract
CMS lists Palmetto GBA for Medicare jurisdiction JM, which includes Virginia, North Carolina, South Carolina, and West Virginia. Medicare local coverage determinations are made by the contractor for its jurisdiction; requirements may differ across jurisdictions.
Before release, we compare each claim with applicable Palmetto guidance. If documentation appears incomplete, we flag it for the practice to review; the treating clinician remains responsible for the record.
Commercial payer examples include Anthem Blue Cross and Blue Shield, CareFirst BlueCross BlueShield, Sentara Health Plans, Aetna, and UnitedHealthcare. Networks and product terms vary by member and service area; confirm eligibility and participation rather than infer coverage from location.
Virginia Medicaid's Cardinal Care Managed Care program uses managed care organizations. DMAS publishes plan and regional provider directories; plan details can change, so confirm the member's assigned plan and current authorization requirements.
Anthem
Billed under Anthem's policy
CareFirst
Billed under CareFirst's policy
Medicare physician fee schedule locality is tied to the applicable ZIP-to-carrier/locality mapping. We check the current CMS crosswalk for the service location rather than infer a rate from a county, city, or state-wide average. Practices near DC may also see members with Maryland or DC plans, so we verify each patient's coverage separately.
So one echo pays differently in Fairfax than in Roanoke. We post each payment against your locality, not a statewide guess. Practices near DC also see patients with Maryland and DC plans, and we verify each one.
When your billing needs a new home, the move follows a 60-day plan. New claims start going out on day 1. Your older A/R is worked on its own track until it clears.
Your biller stays assigned and learns your payers and doctors. You talk to someone who knows cardiology. Mon to Fri, 9 to 5 Central, which is 10 to 6 in Richmond.
Your first 60 days with usThe plan on the patient's card. Anthem and CareFirst each keep their own rules, and we follow the card.
Yes. We confirm the patient's Cardinal Care plan and its authorization rules before the study.
3% of collections, with no setup fee, no contract and no per-claim charges.
Review context: Checked official CMS and Virginia DMAS sources on September 30, 2026. This is an administrative source check, not a clinical review, a claim-level coverage determination, legal advice, or a payment guarantee. CMS's current fee-schedule page links a ZIP-to-carrier/locality file updated August 13, 2026; its separate Locality Key table is labeled 2024. No blanket 2026 locality or payment assertion is made here. DMAS directory files have different posted dates; confirm the current plan, service area, member eligibility, provider requirements, and authorization for each claim.
We review them by study and by payer, free, with no strings.
3% of collectionsNo setup feeNo contract