Cardiology Medical Billing Services in Ohio
AMS Solutions provides specialized cardiology medical billing for practices across Ohio. From Columbus to Cleveland and the rest of the state, our AAPC-certified billers handle the full cardiology code set (93451-93461 catheterization, 92920-92944 PCI, 93306-93308 echo, 93619-93655 EP) and the prior authorization for advanced imaging (CT coronary angiography, cardiac MRI, PET) and structural-heart procedures (TAVR, MitraClip) that Ohio practices need to navigate.
Ohio-specific payer landscape
We work with Ohio Medicaid (Next Generation managed care plans: AmeriHealth Caritas, Anthem, Buckeye, CareSource, Humana, Molina, UnitedHealthcare), plus all major commercial plans: Anthem Blue Cross Blue Shield, Medical Mutual, UnitedHealthcare, Aetna, Humana. Ohio operates under CGS Administrators as the Medicare Administrative Contractor. Ohio uses CGS Jurisdiction 15 — coverage policies are well-published but appeals deadlines are tight.
Cardiology services we bill
Our cardiology billing team handles PCI/cath lab procedures, echocardiography, electrophysiology studies, nuclear cardiology, and cardiac CT/MRI. We’re particularly strong at managing the common modifier 26/TC splits, CTO PCI documentation (92943-92944), and global-period overlaps.
Why Ohio cardiology practices choose AMS
- 33+ years handling Medicare billing across all 8 MAC jurisdictions including CGS
- 95%+ clean claim rate on first submission, vs 85-90% industry average
- 100% U.S.-based billing team — no offshoring, all PHI stays domestic
- HIPAA-compliant with full BAA, encrypted data exchange, role-based access
- AAPC-certified coders — every chart is reviewed by a CPC, COC, or CRC
Frequently asked questions
Yes — every plan listed in Next Generation managed care plans: AmeriHealth Caritas, Anthem, Buckeye, CareSource, Humana, Molina, UnitedHealthcare. We verify benefits before each billing cycle.
We work with all in-state Medicare Advantage plans, commercial plans, and Medicaid MCOs. We verify benefits and authorizations before each catheterization or imaging study.
We track payer-specific bundling rules and apply correct modifiers (26 professional, TC technical, 76 repeat) at the time of charge entry. Our denial rate on cardiology cases is under 5%.
Ready to talk? Call (214) 571-6317 or book a free 30-minute review with our team. We’ll audit a sample of your Ohio cardiology claims at no cost.