How long before selling a cardiology practice should I clean up billing?

Start at least 90 days out, and ideally two full quarters. Buyers reward the trend line, not just the snapshot — they want to see denial rate under 10% across two consecutive clean quarters and a shrinking >90-day A/R bucket. Since MGMA 2024 data shows buyers discount aging above 20%, six months of cleanup gives you time to move that number materially before diligence.

What A/R aging percentage do practice buyers consider a red flag?

Anything above 20% in the >90-day bucket. Per MGMA's 2024 practice-operations survey, most buyers price that aged balance at cents on the dollar rather than face value, treating it as uncollectible. If your cardiology practice carries a 25–30% >90-day bucket, expect the diligence team to write down that receivable and adjust the offer accordingly.

What denial rate do buyers expect from a cardiology practice?

The working benchmark is 12–20%, per Experian Health's State of Claims 2024. Landing above that range typically becomes a direct discount on your offer. Cardiology practices should target under 10% for two consecutive quarters before listing — prior-authorization-heavy services and cardiac imaging codes are the usual denial drivers worth auditing first.

Does recovered revenue from a billing cleanup increase my sale price?

Yes. Recovered leaked revenue flows straight to EBITDA, and practices are valued on an EBITDA multiple — so every dollar recaptured is multiplied at close (HFMA Revenue Cycle Analytics 2024). Reworking a >90-day bucket where roughly half of claims still pay converts dead receivables into valued earnings. Cleaning up before the LOI means you capture that value, not the buyer.

Should I switch billing companies right before selling my practice?

Switch early enough that the new partner produces two clean quarters of reporting before diligence — roughly six months out. Buyers want one source of truth, not four spreadsheets and a PDF. Comparing five vetted partners in parallel on service scope, denial performance, and dashboard reporting takes about a day and costs nothing to evaluate.

Selling a Cardiology Practice: 90-day Billing Cleanup Checklist

EditorialOriginal analysis · M. Kaur, MHA

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

TL;DR

Cardiology practice buyers benchmark your billing shop against a 12–20% denial rate (Experian State of Claims 2024) and price any >90-day A/R bucket above 20% at cents on the dollar (MGMA 2024). For a solo or small cardiology group, a bloated aging report and 15%+ denial rate can shave tens of thousands to low six figures off enterprise value before the LOI is signed. Rework the >90-day bucket — roughly half still pays when resubmitted promptly. Push denials under 10% for two clean quarters. Consolidate reporting into one dashboard buyers can audit.

You spent 20 years building a practice. Now you're ready to sell. Buyers will spend a week inside your billing shop — what they find sets your multiple. Compare five vetted partners to clean up A/R before you go to market.

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.

What buyers actually look at

Practice buyers benchmark billing operations against the same public references you would. Three numbers land in every diligence report.

12–20%Denial-rate benchmark buyers use — higher becomes a discount on offer.Experian State of Claims 2024 [1]

>20%>90-day A/R that most buyers price at cents on the dollar.MGMA 2024 practice-operations survey [2]

EBITDARecovered leaked revenue lands directly here — buyers get it "for free" after close.HFMA Revenue Cycle Analytics 2024 [3]

The single biggest surprise for sellers at diligence is what a clean A/R aging report is worth in dollar terms. Six months of cleanup can move the multiple more than any operational story.

— Roger Strode, JD, healthcare M&A partner (as quoted in MGMA 2024 succession-planning coverage [2])

Three cleanup moves before you list

Resubmit every claim in the >90-day bucket. Roughly half still pay when reworked promptly — and the trend improves optics regardless.
Get denial rate under 10% for two consecutive clean quarters. Buyers reward the trend line as much as the snapshot.
Move to a partner with one clean dashboard. Buyers want one source of truth, not four spreadsheets and a PDF.

Get five quotes to run in parallel

Answer a few quick questions and matched partners reach out within one business day. Compare service scope, denial performance, and reporting side-by-side.

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 33249 · Insertion of Implantable Cardioverter-Defibrillator

National Medicare payment ballpark: ~$2,400–3,500 for the professional component (2024–2025 PFS, MAC-dependent). One of the highest per-claim cardiology values, and one of the most audited — the Medicare National Coverage Determination requires specific EF thresholds and NYHA class documentation. A billing partner that does not audit ICD indication documentation before submission is the wrong partner for an EP-heavy practice.

ICD-10 I21.9 · Acute Myocardial Infarction, Unspecified

Time-limited unspecified code. CMS convention: acute MI codes (I21.-) are appropriate for encounters within four weeks of the initial event; subsequent care should transition to I25.2 (old MI). A billing partner submitting I21.9 six months after the index event triggers audit flags and denials. Confirm the biller's coding team reviews acute-vs-old-MI transitions on every follow-up encounter.

ICD-10 I25.10 · Atherosclerotic Heart Disease Without Angina

The default 'stable CAD' code, and the one most likely to be paired with the wrong imaging or procedure code. When the chart documents any angina — stable, unstable, or documented ischemia — the correct sibling code (I25.110, I25.111, I25.118, I25.119) supports higher-value downstream procedures. Sitting on I25.10 when a subtype is documented forfeits medical necessity for stress testing and elective catheterization.

Sources

[1] Experian Health — State of Claims 2024. https://www.experian.com/healthcare/resources/state-of-claims-2024 [2] MGMA — 2024 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

How long before selling a cardiology practice should I clean up billing?: Start at least 90 days out, and ideally two full quarters. Buyers reward the trend line, not just the snapshot — they want to see denial rate under 10% across two consecutive clean quarters and a shrinking >90-day A/R bucket. Since MGMA 2024 data shows buyers discount aging above 20%, six months of cleanup gives you time to move that number materially before diligence.
What A/R aging percentage do practice buyers consider a red flag?: Anything above 20% in the >90-day bucket. Per MGMA's 2024 practice-operations survey, most buyers price that aged balance at cents on the dollar rather than face value, treating it as uncollectible. If your cardiology practice carries a 25–30% >90-day bucket, expect the diligence team to write down that receivable and adjust the offer accordingly.
What denial rate do buyers expect from a cardiology practice?: The working benchmark is 12–20%, per Experian Health's State of Claims 2024. Landing above that range typically becomes a direct discount on your offer. Cardiology practices should target under 10% for two consecutive quarters before listing — prior-authorization-heavy services and cardiac imaging codes are the usual denial drivers worth auditing first.
Does recovered revenue from a billing cleanup increase my sale price?: Yes. Recovered leaked revenue flows straight to EBITDA, and practices are valued on an EBITDA multiple — so every dollar recaptured is multiplied at close (HFMA Revenue Cycle Analytics 2024). Reworking a >90-day bucket where roughly half of claims still pay converts dead receivables into valued earnings. Cleaning up before the LOI means you capture that value, not the buyer.
Should I switch billing companies right before selling my practice?: Switch early enough that the new partner produces two clean quarters of reporting before diligence — roughly six months out. Buyers want one source of truth, not four spreadsheets and a PDF. Comparing five vetted partners in parallel on service scope, denial performance, and dashboard reporting takes about a day and costs nothing to evaluate.