Cardiology·Published September 2026

From startup to $7.5M: building a cardiology group's revenue engine

MBS joined an East Coast cardiology practice at launch in 2018 and built its revenue cycle from the ground up — through eight years, eight locations, and roughly 80% collections growth since 2021 at a 95%+ clean claim rate.

Annual revenue: $7.54M
Clean claim rate: 95.8%
Denial rate: 4.2%
Collections growth: +80%

Talk about your numbers

Specialty

Cardiology

Practice size

~20,000 patients a year

Locations

8 practices across the East Coast

Top payers

Aetna, Medicare, Medicaid, HealthFirst, ElderPlan

Client tenure with MBS

8 years

Engagement type

Full-suite revenue cycle management

Engagement objective

What the client needed

Set up and manage the practice's revenue cycle functions from launch.
Scale the revenue infrastructure as the practice grew.

Starting position

The challenges

A brand-new practice with no billing infrastructure, payer enrollments, or workflows in place.
Complex cardiology coding across ECHO, vein, and office-based lab procedures.
Diverse payer rules spanning Medicare, Medicaid, and commercial plans.
Continuous growth in locations and credentialed providers to absorb.

Solutions

What MBS put in place

Full-suite revenue cycle management

Payer credentialing, enrollment, eligibility verification, and prior authorization management.
Cardiology-specific coding and compliance audits.
A prior authorization matrix: a monthly cross-check of every authorization change that catches gaps in patient policy status early and recovers revenue otherwise lost to eligibility and authorization errors.

Reporting and MIS

Custom monthly financial dashboards tracking gross charges, net collections, and aging A/R.
Monthly productivity reports by procedure type (ECHO, veins, OBL) to surface the major revenue drivers.
Payer mix analysis identifying which insurers reimburse above peer benchmarks.

Tools, technology, and training

Optimized billing modules and clearinghouse integrations to automate eligibility verification and clean-claim scrubbing.
Workflow management through proprietary software with built-in AI and automation.
Core billing workflows onboarded within 4 weeks of the 2018 launch, expanding as locations and credentials were added.
Ongoing front-desk training on demographic entry, insurance verification, and point-of-service copay collection.

Impact

What changed

$7.54 million in annual revenue collected in 2025, up from $4.18 million in 2021 — roughly 80% growth.
A 95%+ clean claim rate every year: 95.1% in 2024 and 95.8% in 2025.
Denial rate improved from 5.1% in 2024 to 4.2% in 2025, even as claim volume grew.
Revenue infrastructure that scaled with the practice from one site to eight.

Recovery

Annual revenue collection growth

2021 to 2025

2021 to 2025
Year	Revenue collected
2021	$4.18M
2022	$4.27M
2023	$4.98M
2024	$6.28M
2025	$7.54M

Time to first results

Stable cash flow and clean claim tracking were in place within 30 to 45 days of the practice's 2018 launch.

Why it worked

The operating model behind the result

Cardiology coding expertise: deep understanding of complex cardiology coding and diverse payer rules, from Medicare to commercial plans like Aetna, kept denials to a minimum.
Proactive adaptability: over an 8-year tenure, workflows were consistently adapted to evolving regulations and the practice's needs.
A prior authorization matrix that caught policy changes before they became denials.
Reporting built around the procedures that actually drive the practice's revenue.

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