Course Description
This foundational course is designed to equip cardiovascular (CV) professionals, operational staff, and administrative team members with a comprehensive understanding of the CV billing lifecycle. Whether new to CV billing or seeking a refresher, this course delivers critical knowledge to ensure accurate billing, reduce denials, and drive financial performance. Through four structured modules, learners will gain insight into both professional and facility billing processes, recognize common billing challenges, and learn how to track and act on key performance indicators.
The series was developed and presented by Linda Gates-Striby CCS-P ACS-CA, MedAxiom Revenue Cycle Consultant, the Director of Corporate Compliance for St. Vincent Medical group and key expert in Revenue Cycle and Quality, and Nicole Knight LPN,CPC,CCS-P, Executive Vice President, Revenue Cycle Solutions and Care Transformation Services.
- Module 1: Professional Services Billing & Reimbursement Fundamentals
- Module 2: Hospital & Facility Billing Structures in Cardiovascular Care
- Module 3: Common Billing Pitfalls & Denials in CV Programs
- Module 4: Tracking KPIs & Driving Performance in the CV Revenue Cycle
COURSE GOALS
This curriculum is designed to aid CV providers in the proper billing process.
By the end of this course, participants will be able to:
- Understand the distinct reimbursement frameworks for professional and facility CV services.
- Identify and mitigate common billing errors and denial causes within CV programs.
- Apply best practices for claim submission and revenue integrity.
- Monitor and interpret key financial and operational metrics to support ongoing improvement and accountability.
This course is designed for a broad range of professionals supporting or interacting with the cardiovascular revenue cycle, including clinical and non-clinical team members.
For Practice Administrators and Operations Leaders
To support oversight of revenue cycle performance, compliance, and workflow optimization.
For Billing and Coding Staff
To reinforce foundational knowledge specific to cardiovascular services and payer requirements.
For Front Desk, Scheduling, and Pre-Authorization Teams
To understand the upstream impact of patient access functions on billing accuracy and reimbursement outcomes.
For Nursing and Clinical Staff Involved in Orders or Procedure Scheduling
To align clinical workflows with billing processes and reduce preventable denials.
For Revenue Integrity, Coding, Billing and Compliance
To improve collaboration across departments and strengthen performance tracking and denial management.
No prior billing expertise is required, but familiarity with cardiovascular services and terminology is recommended for optimal comprehension.
REQUIRED TEXTS, MATERIALS, OR EQUIPMENT
Participants should have access to the following materials and tools to reference throughout – AMA CPT® Professional, ICD-10 CM Diagnosis Coding
Electronic Links Available in each Module: AMA, CMS, HFMA , and other online Articles.
THE METHODOLOGY
Each lesson has a 60-90 minute didactic video detailing the week’s focus.
This is a pass/fail course based on the completion of the material. Students must pass an exam upon module completion with an 80 percent or above and the final course evaluation feedback survey to receive a certificate of completion.
COURSE GRADING
Statement of Grading Approach or Philosophy:
Each enrollee will have a maximum of 12 months to complete the course material. Users must pass every quiz with a score of 80 percent or above, and the final course evaluation feedback survey to receive the CEU credits and certificate of completion.
Weekly Breakdown of Hours:
- Week 1: 1.5
- Week 2: 1.5
- Week 3: .5
- Week 4: .5
SCHEDULE OF TOPICS AND LEARNING OBJECTIVES
Disclaimer: The instructors reserve the right to make modifications to this course material as needed.
Preliminary Schedule of Topics, Learning Objectives, Readings and Quizzes
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MODULE
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TOPIC/LEARNING OBJECTIVES
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1
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Topic: Professional Services Billing & Reimbursement Fundamentals
Learning Objectives:
- Understand how physician and advanced practice provider services are billed, including E/M coding, procedural billing, modifiers, and the Medicare Physician Fee Schedule (MPFS). Learn about requirements, payer rules, and common pitfalls that affect payment for CV services.
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2
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Topic: Hospital & Facility Billing Structures in Cardiovascular Care
Learning Objectives:
- Explore the structure of hospital billing for inpatient and outpatient cardiovascular services, including MS-DRG and APC methodologies, revenue codes, and the relationship between documentation, coding, and reimbursement.
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3
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Topic: Common Billing Pitfalls & Denials in CV Programs
Learning Objectives:
- Review the most frequent billing errors and denial reasons specific to cardiology services—such as authorization issues, charge capture gaps, and coding discrepancies. Participants will learn strategies for prevention, root cause analysis, and cross-functional workflow improvement.
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4
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Topic: Tracking KPIs & Driving Performance in the CV Revenue Cycle
Learning Objectives:
- Learn how to track and interpret key performance indicators (KPIs) such as denial rates, days in A/R, charge lag, and first pass yield. Understand how to turn data into action by establishing accountability structures, identifying trends, and implementing timely interventions.
Additional Resources
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