What is a good denial rate for a cardiology billing company?

Ask for a specialty-specific first-pass denial rate covering the last twelve months, not a marketing average. Top-quartile RCM operations quote under 10%, per Experian Health's State of Claims 2024. Cardiology denials concentrate in prior-auth and medical-necessity edits on studies like 93306 echocardiography and 93458 diagnostic catheterization, so a partner without cardiology-level data is guessing.

How much do cardiology billing services cost?

Most outsourced RCM contracts price at roughly 4–9% of net collections, so a cardiology practice collecting $700,000 annually pays about $28,000–$63,000 per year. Percentage alone is not the comparison. Get a written all-in scope covering implementation, per-claim or per-encounter fees, credentialing, denial rework, and reporting — ambiguity in scope is where surprise invoices originate.

What percentage of A/R over 90 days is acceptable?

Under 15% of total A/R past 90 days is healthy; HFMA's 2024 revenue cycle benchmarks put well-run shops under 20%. Anything materially above 20% warrants a direct follow-up on payer mix, front-end eligibility checks, and whether denied cardiology claims are actually being worked or just aging quietly in a queue.

How fast should a billing company resubmit denied claims?

Within 14 days. The industry median resubmit rate at that mark sits near 50% per MGMA's 2024 practice operations data, while partners worth signing run comfortably above 85%. Timely filing windows with Medicare MACs and commercial payers are unforgiving, so slow rework converts recoverable cardiology revenue into permanent write-offs.

What should I ask a billing company on the first demo call?

Five things: your specialty's twelve-month denial rate, the percent of denials resubmitted within 14 days (target above 85%), average A/R past 90 days (target under 15%), the named person you call when a claim breaks, and the all-in written quote. Ticket queues instead of one named contact stretch rework loops from hours into days.

5 Questions to Ask a Cardiology Billing Partner in 2026

EditorialOriginal analysis · M. Kaur, MHA

By M. Kaur, MHAAugust 11, 2026Updated August 29, 2026Blog Post

TL;DR

Outsourced cardiology billing typically runs 4–9% of collections, so a solo practice collecting roughly $700,000 a year pays about $28,000–$63,000 for the service — which makes vendor diligence a real dollar decision. Five diagnostic questions separate operators from pitches: specialty-specific first-pass denial rate (top-quartile shops quote under 10% per Experian's State of Claims 2024), 14-day resubmit rate (industry median near 50%, strong partners above 85%), and A/R past 90 days (healthy is under 15–20%). Ask who answers when a 93306 echo or 93458 cath claim breaks, and get all-in scope in writing.

Every billing pitch mentions clean claims, low denials, and fast A/R. The differences show up in how partners answer specific diagnostic questions. Ask these five on every demo — matched partners will reach out within one business day when you fill in the form below.

Ready to compare?

Answer a few quick questions and matched partners will reach out within one business day. You choose who to talk to — there's no obligation.

The industry baseline

Before comparing pitches, know the numbers a strong partner should hit. Anything materially below these is either weak operations or careful wording.

<10%First-pass denial rate a top-quartile RCM operation quotes by specialty.Experian State of Claims 2024 [1]

85%+Denied-claim resubmit rate within 14 days at a healthy partner.MGMA 2024 practice-operations survey [2]

<20%Share of A/R past 90 days at a well-run shop.HFMA Revenue Cycle Analytics 2024 [3]

The five questions

What is your denial rate for my specialty? If they don't quote a specialty-specific number in the first call, they don't have the data. Ask for the last twelve months, not a marketing average.
What percent of denied claims do you resubmit within 14 days? The industry median hovers near 50% [2]; a partner worth signing is comfortably above 85%.
What is your average >90-day A/R for practices like mine? Below 15% is healthy. Above 20% deserves a follow-up on why.
Who do I call when a claim breaks? One name, one number. Ticket queues stretch rework loops from hours to days.
What is included in the quote, all-in? Ask for a written scope covering setup, per-claim fees, and reporting. Ambiguity here becomes surprise invoices later.

The best diagnostic on any billing vendor isn't their pitch — it's whether they'll quote denial and A/R metrics by specialty on the first call.

— Elizabeth Woodcock, MBA, FACMPE — practice-operations author cited by MGMA [2]

Get five quotes to put through the checklist

Answer a few quick questions and matched partners reach out within one business day. You pick who to interview.

CPT/ICD Codes Cardiology Billers Must Master

Below is a working reference of codes cardiology billers touch most often, alongside the denial triggers that show up first in a partner review. Fee-schedule numbers are national Medicare Physician Fee Schedule (2024–2025) ballparks; actual reimbursement varies by Medicare Administrative Contractor jurisdiction and payer contract.

CPT 93010 · Electrocardiogram, Interpretation and Report Only

Interpretation-only component paid separately from the technical component. National Medicare payment ballpark: ~$8–12 (2024–2025 PFS, geographic locality varies). Common denial: billed by a physician who did not sign the report, or billed when the technical component was already bundled under 93000. A partner that catches this at claim scrub, not at appeal, is worth the switching cost on its own.

CPT 93306 · Echocardiography, Complete with Doppler and Color Flow

National Medicare payment ballpark: ~$180–240 (2024–2025 PFS, MAC-dependent), often the single largest recurring cardiology CPT after office visits. Denial triggers: incomplete documentation of all four required components (2D, M-mode, spectral Doppler, color-flow Doppler) or a mismatched ICD-10 that does not support medical necessity under the local coverage determination.

ICD-10 I50.9 · Heart Failure, Unspecified

Highest-risk unspecified code in the cardiology ICD stack. Payers increasingly deny E/M and imaging claims that lean on I50.9 when a more specific code (I50.22 for chronic systolic, I50.32 for chronic diastolic, I50.42 for combined) is supported by the chart. A billing partner that queries the physician for specificity rather than submitting the unspecified default is the difference between a paid claim and a rework loop.

ICD-10 I48.91 · Atrial Fibrillation, Unspecified

Similar unspecified-code trap. Payers prefer I48.0 (paroxysmal), I48.1 (persistent), I48.2 (chronic), or I48.21 (permanent) whenever the chart supports it. Anticoagulation-related billing (CPT 93793 for warfarin management, or E/M weighting for DOAC counseling) hinges on a specific AF subtype. Ask a prospective biller how many I48.91 defaults their scrub caught and requeried in the last quarter.

Sources

[1] Experian Health — State of Claims 2024. https://www.experian.com/healthcare/resources/state-of-claims-2024 [2] MGMA — 2024 Annual Report & Practice Operations Survey. https://www.mgma.com/data [3] HFMA — Revenue Cycle Analytics Report, 2024 edition. https://www.hfma.org/topics/revenue-cycle/

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Answers

What is a good denial rate for a cardiology billing company?: Ask for a specialty-specific first-pass denial rate covering the last twelve months, not a marketing average. Top-quartile RCM operations quote under 10%, per Experian Health's State of Claims 2024. Cardiology denials concentrate in prior-auth and medical-necessity edits on studies like 93306 echocardiography and 93458 diagnostic catheterization, so a partner without cardiology-level data is guessing.
How much do cardiology billing services cost?: Most outsourced RCM contracts price at roughly 4–9% of net collections, so a cardiology practice collecting $700,000 annually pays about $28,000–$63,000 per year. Percentage alone is not the comparison. Get a written all-in scope covering implementation, per-claim or per-encounter fees, credentialing, denial rework, and reporting — ambiguity in scope is where surprise invoices originate.
What percentage of A/R over 90 days is acceptable?: Under 15% of total A/R past 90 days is healthy; HFMA's 2024 revenue cycle benchmarks put well-run shops under 20%. Anything materially above 20% warrants a direct follow-up on payer mix, front-end eligibility checks, and whether denied cardiology claims are actually being worked or just aging quietly in a queue.
How fast should a billing company resubmit denied claims?: Within 14 days. The industry median resubmit rate at that mark sits near 50% per MGMA's 2024 practice operations data, while partners worth signing run comfortably above 85%. Timely filing windows with Medicare MACs and commercial payers are unforgiving, so slow rework converts recoverable cardiology revenue into permanent write-offs.
What should I ask a billing company on the first demo call?: Five things: your specialty's twelve-month denial rate, the percent of denials resubmitted within 14 days (target above 85%), average A/R past 90 days (target under 15%), the named person you call when a claim breaks, and the all-in written quote. Ticket queues instead of one named contact stretch rework loops from hours into days.