Who we serve · Cardiology

Cardiology practices. Every study authorized, billed in the right halves and followed to payment.

HRI Med brings Health Revenue Intelligence's revenue-cycle work to independent cardiology practices. We enroll the practice and every cardiologist, nurse practitioner and physician assistant with each payer, request imaging and procedure authorizations before the test, and bill the professional and technical parts of each study to the party that owes them.

Request a review Where payers push back

iWhere payers push back

Authorizations, split studies and hospital reads.

UnitedHealthcare's commercial plans, for one, require prior authorization for echocardiograms, stress echocardiograms, diagnostic catheterizations and electrophysiology implants done in an office or outpatient setting.^A Its imaging program adds nuclear cardiology.^B Every other plan keeps its own list.

Under that same imaging program, the claim can be denied on administrative grounds and the patient cannot be billed. The reading cardiologist's professional claim survives a missed authorization, while a medical-necessity denial takes every part of the study with it.^B

Most cardiac tests come in two parts. The technical part is the equipment, the room and the staff. The professional part is the reading and its written report. Medicare prices the whole test and each part separately.^C When the study happens in the hospital, the hospital bills the technical part. The practice bills the read alone, with modifier 26 and the place-of-service code for where the patient had the test, even if the cardiologist read it from the office.^D A whole-test claim for a hospital study is wrong before any payer reads it.

A cardiologist who reads at more than one hospital and sees patients at several offices needs every location and every link to the group on file. In Medicare, the clinician reassigns the right to be paid to the group, now reported on the CMS-855I.^E When another physician orders the test, Medicare covers the imaging only if that physician is enrolled in Medicare or has opted out.^F

iiWhat we run

One file from the referral to the payment.

Enrollment: The practice, each office and every cardiologist, NP and PA, with Medicare through PECOS, your state's Medicaid plans and the commercial plans on your list. Hospital reading sites and reassignments kept current, each application followed to an effective date.
Authorizations: Requested before the test, against the payer's own criteria, and tracked until the plan answers in writing.
Claims: Each study billed whole, as the read alone or as the technical part alone, depending on where it happened and who owns the equipment.
Denials: Sorted into administrative and medical-necessity denials, because each is fought differently, then appealed where the practice is owed.
The Friday board: Each open application and, once we bill, each study that week that was paid, denied or paid short.

Enrollment fees for a cardiology group. The full card is on the pricing page.
Piece of work	Fee
The practice, with each payer	$350
Each cardiologist, NP or PA, with each payer	$250
A clinician's CAQH ProView profile (CAQH now operates as DataSpring), built or repaired	$150
Billing and revenue cycle	By agreement

Total your own enrollment with the calculator.

iiiQuestions

Common questions from cardiology practices.

If we miss an authorization, do we lose the reading fee too?

Under UnitedHealthcare's commercial imaging program, no. The professional claim survives a missed authorization, and a medical-necessity denial takes the whole study. Other plans set their own rules, and we write them down for every plan on your list.

A new cardiologist starts reading at the hospital soon. What has to be filed?

A practitioner application for the new cardiologist with each payer at $250, plus $150 if the CAQH profile needs building. For Medicare we also file the reassignment to your group and list each hospital site.

Can you take over billing from our current company?

Yes. We work inside your current system where we can, and plan the handover so no open claim or pending authorization is dropped. How billing runs

Sources

UnitedHealthcare, commercial prior authorization requirements, cardiology. Read 2026.
UnitedHealthcare, outpatient radiology prior authorization FAQ. Read 2026.
CMS, Medicare Claims Processing Manual, chapter 12, sections 20.2 and 90.4.5. Read 2026.
CMS, Medicare Claims Processing Manual, chapter 13, sections 20.2.1 and 150. Read 2026.
CMS, consolidated CMS-855I and CMS-855R bulletin. Read 2026.
CMS, Ordering and Certifying. Read 2026.

Send us the studies your payers keep turning back.

Name the tests, the payers and where each study happens. We read them against each plan's rules, with no patient information involved.

Mention any study a payer now sends to an outside reviewer for approval.

Request a review