- AI-Powered Cardiology RCM
Cardiology Medical Billing, Automated Where It Should Be — and Worked by Specialists Where It Matters
Cath lab, echo, EP, stress testing and device monitoring each carry their own prior-authorization rules, modifiers and payer edits. Our automated system checks eligibility and scrubs every claim before it reaches a payer, while certified cardiology coders handle appeals, complex cases and anything that needs judgment.
- 98.6% clean claim rate
- 28-34 days in A/R
- 24 hrs denial routing
- Live claim monitor — Cardiology
- Today, 9:41 AM
Eligibility — Cath lab, Pt #4471
Prior auth — Echo w/ Doppler
Claim scrub — CPT 93458, 93459
Denial routed — Modifier 26/TC
RPM cycle — 16-day threshold
What is cardiology medical billing?
Cardiology medical billing is the coding and claims process for cardiovascular services — office visits, echocardiograms, stress tests, cardiac catheterization, electrophysiology and device monitoring. It depends on precise CPT, ICD-10 and modifier use, and most interventional and imaging services require prior authorization before the claim is ever filed.
- Does This Sound Like Your Practice?
The six things cardiology practices tell us right before they call
We didn't write this list from a textbook — it's what practice managers and cardiologists actually say on the first call. If two or three of these hit close to home, the problem isn't your staff. It's that cardiology billing has more failure points than almost any other specialty, and nothing is catching them before they cost you money.
"We lose a full week every month just chasing prior auths."
Revenue at risk: Cath, PCI and device implants are denied outright without authorization on file — no appeal fixes a missing auth.
"Our front desk is on hold with payers more than they're with patients."
Cost to your practice: Every hour on eligibility calls is an hour not spent on scheduling, check-in or patient experience.
"Denials pile up faster than anyone can appeal them."
Cost to your practice: Modifier 26/TC errors on echo and nuclear studies are routine — and routinely missed the appeal deadline.
"We don't find out a claim is stuck until the deposit doesn't show up."
Cost to your practice: No visibility means no early warning — just a smaller deposit and a scramble to figure out why.
"Our RPM and CCM billing is a mess — nobody tracks the thresholds."
Revenue at risk: Recurring monitoring codes billed early, late or not at all quietly cost more than any single denial.
"Good billing staff keep burning out and leaving."
Cost to your practice: When the job is all repetitive phone calls and re-keying data, turnover becomes the real expense.
- The Resolute MSO Difference
How our AI-powered automated system runs cardiology billing
Automation doesn't replace your billing team — it removes the repetitive checks so certified coders spend their time on appeals, complex cath and device claims, and anything that genuinely needs a decision.
Eligibility and prior auth verified before the appointment
Coverage, benefits and authorization status for cath lab, imaging and device procedures are confirmed automatically ahead of the visit — not discovered after the claim is denied.
Claims scrubbed against cardiology-specific edits
Every claim is checked against payer rules and coding edits for echo, nuclear cardiology, EP studies and cath procedures — including modifier logic — before it ever reaches the payer.
Denials categorized and routed automatically
A denial for missing prior auth, a medical-necessity edit or a modifier error is automatically sorted by root cause and assigned to a coder for appeal, typically within 24 hours.
Recurring monitoring codes tracked automatically
Remote physiologic monitoring and chronic care management time thresholds are tracked against each patient's cycle, so recurring codes are billed on schedule instead of missed at month-end.
One dashboard, real-time status
A live dashboard shows where every cardiology claim stands — verified, submitted, paid or denied — without a phone call to your billing company.
- Full Scope
Cardiology billing services, end to end
Cath lab & interventional billing
Diagnostic and interventional catheterization, PCI and stent procedures with prior-auth tracking built in.
Echocardiography billing
Transthoracic, transesophageal and stress echo billed with correct 26/TC modifier splits.
Nuclear cardiology & stress testing
Myocardial perfusion studies and stress tests coded against current payer imaging edits.
Electrophysiology (EP) billing
Ablations, device implants and EP study coding for complex rhythm-management cases.
Cardiac device & RPM monitoring
Remote physiologic monitoring, pacemaker/ICD interrogation and chronic care management on a tracked monthly cycle.
Certified cardiology coding
AAPC-certified coders assign and audit CPT, ICD-10 and HCPCS codes specific to cardiovascular care.
Prior authorization management
Authorization requests, clinical submission and status tracking completed before the procedure date.
Denial management & appeals
Root-cause denial work and appeals, with prevention rules so the same denial stops repeating.
Credentialing & payer enrollment
Payer applications and re-credentialing so your cardiologists stay in-network without gaps.
- Automated RCM
AI-Powered Cardiology Medical Billing Services
Add a single AI product that fixes your biggest bottleneck or integrate our complete AI Ecosystem into your billing. Either way, each one integrates into your cardiology revenue cycle management.
HealUs-EHR
Our electronic health record system syncs cardiology clinical records with billing and coding.
Salus-AI Scribe
Our AI Medical Scribe captures your cardiology patient visit as structured clinical documentation.
Sophus-AI Coder
Resolute MSO’s AI Coder assigns cardiology CPT, ICD-10 and HCPCS codes with the right modifiers.
Maximus-PMS
Resolute MSO’s PMS helps with cardiology scheduling, charge entry, claim submission and status.
- Manual vs. Automated
The difference automation makes on cardiology claims
Process
Manual (industry avg.)
Resolute MSO
Clean claim rate
82–88%
98.6%
Prior auth tracking
Manual follow-up calls
Verified before the visit
Modifier accuracy (26/TC)
Caught after denial
Checked pre-submission
Denial follow-up
Queue-based, no root cause
Auto-routed within 24 hrs
RPM/CCM cycle tracking
Spreadsheet, easy to miss
Tracked automatically per patient
Claim status visibility
By phone or email
Real-time dashboard
- Getting Started
How the cardiology billing transition works
Four steps from your first conversation to a cardiology billing operation you don't have to chase.
Audit
Review
We review your cardiology collections, denial patterns, A/R aging and coding, and send written findings.
Design
Map the workflow
We map your payers, procedure mix and EHR into a workflow with cardiology-specific automation rules built in.
Transition
Connect systems
We connect to your EHR, complete payer enrollments and run a parallel period so no claim drops in the switch.
Operate
Run & report
Daily claim work, denial prevention and reporting on cath, echo, EP and monitoring revenue you can actually read.
- Works With Your Systems
Integrated with the EHR platforms cardiology practices already use
"Prior auth denials on our cath lab claims were eating a full-time staff member's week. Within two months of moving to Resolute, authorization was verified before the patient ever arrived, and our clean claim rate on interventional cases stopped being a monthly problem."
Practice Manager, 12-provider cardiology group, Mexico
- Frequently Asked Questions
Got Questions?
We've Got Answers
Cardiology medical billing FAQs
Cardiology medical billing is the process of coding and submitting claims for cardiovascular services — office visits, echocardiograms, stress tests, cardiac catheterization, electrophysiology and device monitoring — then following those claims through payment, denial or appeal.
Most commonly: missing prior authorization on interventional or imaging procedures, incorrect professional (26) versus technical (TC) modifier use, medical-necessity mismatches between diagnosis and procedure codes, and incomplete documentation on recurring monitoring services.
Automation checks eligibility and prior-authorization status before the appointment, scrubs each claim against cardiology-specific payer edits before submission, and routes any denial to a coder by root cause within 24 hours instead of letting it sit in a queue.
Yes. We bill remote physiologic monitoring, remote cardiac monitoring and chronic care management codes on their required monthly cadence, with automated tracking of time and data thresholds.
We integrate with major cardiology-compatible EHR and practice management platforms including NextGen, athenahealth, AdvancedMD, CareCloud, Epic, eClinicalWorks, Kareo and CollaborateMD, among 50-plus systems.
Pricing is a percentage of collections starting at 2.99%, with the exact rate depending on claim volume and the mix of interventional, imaging and cognitive services billed. No flat monthly fees, no long-term contracts.
