High-value claims deserve a second look
Echocardiograms, nuclear studies, catheterizations, and device monitoring all carry authorization and medical-necessity requirements. When one of these is denied, the appeal takes weeks and the write-off is large.
We treat these claims as a separate queue with their own checks: authorization on file, diagnosis supporting necessity, and the technical and professional components billed correctly.
- Prior authorization and medical necessity documentation
- Global-period and post-operative visit billing
- Technical versus professional component splits
- Remote monitoring and device follow-up codes
Reading the numbers with your team
Cardiology groups usually have enough volume to see patterns quickly. The useful reports are narrow: which procedure families are denied, why, and how long appeals take to resolve.
We review those with your administrator monthly, agree on one or two corrections, and leave the rest alone. Changing ten things at once usually means changing nothing.