From prior authorizations on complex cardiac procedures to denial management and chronic care coding — SCALE delivers revenue cycle intelligence purpose-built for cardiology groups, health systems, and MSOs.
Cath lab, stress testing, device implants & imaging
EP, nuclear imaging, interventional & office-based CPTs
Payer-specific workflows for cardiac claim disputes
Chronic care & remote monitoring billing programs
Live dashboards via SCALE's analytics platform
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Cardiac catheterizations, stress tests, echocardiograms, and device implants require intensive prior authorization workflows that stall revenue and frustrate care teams.
Cardiology spans hundreds of CPT codes — from nuclear imaging to electrophysiology studies — each with unique documentation, bundling rules, and payer-specific policies.
Cardiology denials hit on two fronts — high-volume, low-margin claims (visits, diagnostics, CCM) where leakage compounds at scale, and high-value procedures (cath, device implants, EP) where one denial puts thousands at risk.
Core Service
We manage the full prior auth lifecycle for your highest-volume cardiac procedures — from submission to peer-to-peer reviews. Our team knows the clinical criteria and payer policies that get authorizations approved faster.
AI-Powered
Automated charge review flags undercoded encounters, missed bundling opportunities, and documentation gaps across all cardiology CPT families — from cath lab to office-based procedures.
Denial Recovery
Specialized cardiac denial workflows with payer-specific appeal templates for common denials — medical necessity, modifier disputes, and global period violations — get you paid faster.
Specialty Coding
SCALE identifies eligible chronic care and remote patient monitoring patients, closes documentation gaps, and manages billing for these high-margin programs your practice is already delivering.
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
