Phone Number
+1 (734) 418-7995
Phone Number
+1 (734) 418-7995
Cardiology Billing Services
Cardiology Billing Services
Cardiology-only medical billing, serving Louisiana practices

Cardiology billing built for Louisiana’s payer landscape

A Michigan-based, cardiology-only billing team supporting cardiovascular practices across Louisiana fluent in Healthy Louisiana’s managed-care plans, Novitas Jurisdiction H Medicare, and the state rules your claims actually run on. We’re not a local Baton Rouge office pretending otherwise; we’re specialists who know exactly which rules apply here.

5 MCOs
Healthy Louisiana managed-care plans we bill and follow up
Jur. H
Medicare through Novitas Solutions, alongside six other states
365-day
Medicaid fee-for-service filing window under state code
180-day
Medicare crossover window for dual-eligible cardiac patients
The Louisiana payer landscape

Three payer worlds, each with its own rulebook

Louisiana claims don’t move through one statewide fee schedule. A cardiac patient’s claim is governed by which of these three systems covers them and each carries its own edits, authorization lists and medical policy.

Medicaid

Healthy Louisiana, managed care

Benefits are delivered almost entirely through managed-care organizations, so most Medicaid-covered cardiac patients are billed under an MCO’s own claim edits, prior-authorization list and timely-filing rules.

Aetna Better Health AmeriHealth Caritas Healthy Blue Humana Healthy Horizons LA Healthcare Connections

UnitedHealthcare Community Plan’s contract ended March 31, 2026 device, cath and imaging authorizations had to be tracked as patients moved to newly assigned plans.

Medicare

Jurisdiction H, Novitas Solutions

Louisiana is processed with Arkansas, Colorado, Mississippi, New Mexico, Oklahoma and Texas. Novitas’ Local Coverage Determinations define medical necessity for cardiovascular diagnostic testing.

Stress testing LCDs Echocardiography Nuclear imaging

The same JH-wide criteria apply whether a claim originates in Shreveport or Amarillo documentation has to satisfy them either way.

Commercial

Blue Cross and Blue Shield of Louisiana

The commercial market is anchored by an independent nonprofit licensee that writes its own medical policy, separate from Anthem and other Elevance-affiliated Blues plans.

Independent policy Fully-insured rules ERISA self-funded

Assuming national BCBS policy applies uniformly is a trap and self-funded ERISA plans, common among large Louisiana employers, sit outside state prompt-pay protection entirely.

Why cardiology, why here

General billing misses what cardiology claims require

Diagnostic testing echocardiography, nuclear imaging, stress testing carries a technical and a professional component, and how that split is billed depends heavily on where the test is performed.

Ochsner Health and LCMC Health have absorbed a growing share of Louisiana’s cardiologists as employed physicians, often working inside hospital-owned outpatient departments. When that happens, the technical component of an echo or stress test is typically billed by the facility not folded into the physician’s global claim. Getting the place-of-service code and component split wrong is one of the most common denial sources for groups that recently moved from independent to hospital-employed, or that split time across both.

Cardiac catheterization adds another layer. Louisiana’s health-planning rules expect these procedures inside hospital-based programs with cardiovascular surgery support nearby, so most cath and interventional claims carry a facility component that must be coordinated with the physician’s professional claim on top of the modifier and medical-necessity requirements every interventional procedure faces nationally.

What we handle

Full-cycle billing and coding, cardiology-specific

The same specialty standard we apply everywhere, run against the payer rules that actually govern claims in Louisiana.

Medical billing, charge to payment

The full cycle for diagnostic, interventional and device-related services from charge entry through resolved payment.

Eligibility & prior authorization

Verified before procedures that require it, including the MCO-specific authorization lists each Healthy Louisiana plan maintains.

CPT, ICD-10-CM & HCPCS coding

Built around medical necessity and correct modifiers including the technical/professional splits that come up constantly here.

Claims submission & tracking

Scrubbed against payer-specific edits, then monitored so a rejection is fixed before the 30-day clean-claim clock runs out.

Payment posting & coding audits

Receipts reconciled against contracted rates, with audits that keep coding defensible under payer review.

Denial management

Denied claims traced to a root cause and corrected not simply resubmitted and hoped through a second time.

Deadlines & protections that shape the work

The Louisiana rules that catch billing teams off guard

365days
Medicaid fee-for-service filing
The window for FFS claims that fall outside MCO coverage, set by the state administrative code.
180days
Medicare crossover for duals
A much shorter window from Medicare’s adjudication date easy to miss when you track one deadline.
30days
MCO clean-claim payment
Healthy Louisiana MCOs pay clean claims within 30 days or begin accruing interest a concrete follow-up benchmark.

On the commercial side, Louisiana Revised Statute 22:1821 generally requires insurers to pay within 30 days of proper proof of claim, and the Department of Insurance sets an even shorter standard for electronic claims. But that protection covers fully-insured plans only not the self-funded ERISA plans common among the state’s larger employers.

Hurricane season is a billing factor, not a footnote

CMS has repeatedly issued Section 1135 disaster waivers for Louisiana providers Katrina, Laura, Ida and, most recently, Hurricane Francine in September 2024 adjusting enrollment screening, claims timelines and durable-medical-equipment replacement for beneficiaries who lost devices during an evacuation. For patients with pacemakers, defibrillators or remote monitoring, a storm-related service gap is real, and knowing how to document and bill around a declared emergency is a recurring part of the job here.

Waiver requirements are time-limited and specific to each declared event, so current guidance is always verified against CMS and Louisiana Department of Health bulletins rather than carried over from a prior storm.

Our revenue-cycle workflow

Six steps, each with a Louisiana checkpoint

1

Eligibility & authorization confirmation

Checked against the specific Healthy Louisiana MCO or commercial plan on file because assuming an approval carried over from a prior plan year or MCO assignment is one of the most preventable denials.

2

Charge capture & coding review

CPT, ICD-10-CM and modifier accuracy verified against payer-specific edits before a claim ever leaves the building.

3

Electronic submission & tracking

Claims tracked through payer systems, with rejections corrected against Jurisdiction H or MCO-specific requirements before they age into formal denials.

4

Payment posting & underpayment flags

Receipts reconciled against contracted rates underpayments are flagged and worked, not quietly absorbed.

5

Accounts-receivable follow-up & appeals

Unresolved claims move into structured follow-up and appeals rather than sitting until the filing window closes.

6

Reporting that closes the loop

Denial patterns and revenue trends visible on demand no chasing down a status update to see where things stand.

What we’re usually brought in to fix

The denials Louisiana cardiology practices see most

Diagnostic-testing medical necessity

Stress testing and advanced imaging denied when documentation doesn’t clearly meet Novitas Jurisdiction H criteria.

Authorizations that don’t transfer

Prior approvals lapsing when a patient is reassigned to a new MCO a live issue during the 2026 UnitedHealthcare exit.

Facility-vs-professional confusion

The technical component of an echo or nuclear study billed on the physician side when it should have gone through the facility.

Modifier 25 and 59 misuse

Two of the most scrutinized modifiers in cardiology, and a frequent trigger for edits and takebacks when applied loosely.

Underpayments below contracted rates

MCO payments that don’t match the contracted rate caught only when someone reconciles against the contract.

Aging Medicaid crossover receivables

Dual-eligible crossover claims stalling and aging past the shorter 180-day window before anyone works them.

Coverage across the cardiovascular service line

Specialties and procedures we bill

Specialties supported
General cardiology Interventional cardiology Electrophysiology Cardiac imaging Heart failure management Structural heart disease Cardiac rehabilitation Pediatric cardiology Cardiothoracic surgery
Procedures we code
EKG / ECG interpretation Echocardiography Stress testing Holter & event monitoring Cardiac catheterization Device-related procedures Interventional procedures

Each coded with attention to the technical/professional splits and facility considerations that come up so often in Louisiana’s hospital-affiliated practices.

Let’s look at your claims

Spend the time on patients, not on denials

If claim denials, MCO authorization gaps or aging Medicaid crossover receivables are eating into time your practice would rather spend on patients, we’re glad to review where things stand and where a cardiology-specific team could tighten it up.

Questions Louisiana practices ask us

Frequently asked questions

Do you provide cardiology billing services in Louisiana?
Yes. We’re a Michigan-based cardiology billing company serving practices nationwide, including cardiovascular groups across Louisiana. Our coders work exclusively in cardiology and stay current on the Healthy Louisiana MCO landscape and Jurisdiction H Medicare rules that apply to claims here.
Do you handle Healthy Louisiana Medicaid billing?
Yes. We bill and follow up across Louisiana’s Medicaid managed-care organizations Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons and Louisiana Healthcare Connections tracking each plan’s own prior-authorization and timely-filing requirements rather than treating Medicaid as a single fee schedule.
Do you support Medicare claims through Novitas Solutions?
Yes. Louisiana falls under Medicare Administrative Contractor Jurisdiction H, administered by Novitas Solutions. We work within the Local Coverage Determinations Novitas publishes for cardiovascular diagnostic testing and apply the documentation standard those policies require.
Can you help with denials tied to Louisiana’s MCO transitions?
Yes. Denial management and root-cause analysis are core to what we do, including the authorization-continuity issues that surface when a Medicaid managed-care assignment changes as it did for many practices during the 2026 UnitedHealthcare exit from Healthy Louisiana.
Do you work with both independent and hospital-employed cardiologists?
Yes. Independent practices and cardiologists employed within larger systems have different billing patterns, particularly around technical-versus-professional component splits for imaging and procedures performed in hospital-owned settings. We bill for both arrangements.