Every prior authorization, built to the payer’s own checklist.
CardioAuth is prior authorization software for cardiology practices. It pulls the evidence from your chart, checks it against each payer’s criteria for the procedure, and assembles the package, so you know a request is complete before it goes out.
Example requestCoronary CT angiographyUnitedHealthcare, Choice Plus
Ready to submit
Approval estimate97%
Symptoms documented in an office noteOffice note attached from the EHR
Prior stress test non-diagnosticTreadmill report attached
Intermediate pretest probabilityFrom the assessment
No coronary CTA in the last 12 monthsChecked in the chart
Ordering cardiologist and NPIFilled in from the order
Cover sheet, letter of medical necessity and criteria crosswalkSubmit to UnitedHealthcare
How a request goes
From the schedule to the payer’s decision, your team works in one place. Here’s one coronary CT angiography, start to finish.
A sample schedule from the EHR with four upcoming procedures. The coronary CT angiography for a UnitedHealthcare patient needs prior authorization, and one click starts its request.
Staff sign in to the EHR once a day. Upcoming procedures show whether each patient’s payer needs prior authorization.
Fri 1:00R. DelgadoHolter monitorCheck the planHumana
Sample patients
The payer’s checklist for the coronary CT angiography. Notes from the chart attach to the criteria they support, each criterion is checked off, and the approval estimate climbs to 97%.
The chart fills in the request, and recent notes are filed under the criteria they support. The estimate climbs as evidence arrives.
Coronary CT angiographyUnitedHealthcare
Approval estimate
Symptoms documentedOffice note, from the EHR
Prior stress test non-diagnosticTreadmill stress test report
Intermediate pretest probabilityAssessment and plan
No coronary CTA in 12 monthsImaging history
Each note is filed under the criterion it supports.
The submission package: a cover sheet, a letter of medical necessity written from the checklist, the criteria crosswalk and the supporting notes, combined into one PDF, ready for the payer’s portal.
The cover sheet, the letter of medical necessity and the criteria crosswalk come together as one PDF for the payer’s portal.
Submission packageOne PDF, 9 pages
Cover sheet
Letter of medical necessity
Criteria crosswalk
Office note
Treadmill stress test
Letter of medical necessity
Re: coronary CT angiography for W. Kowalski.
Exertional chest pain is documented in his recent office note.
His treadmill stress test was non-diagnostic, and his pretest probability is intermediate.
He meets each of UnitedHealthcare’s criteria for this test.
Package readyOpen the payer’s portal
Tracking the decision: submitted, waiting on the payer with the deadline tracked, then approved with the authorization number recorded. If a payer denies, the appeal letter and peer-to-peer prep are ready.
Deadlines and decisions stay on your list. If a payer denies, the appeal letter and peer-to-peer prep are ready.
Coronary CT angiographyUnitedHealthcare
Submitted to UnitedHealthcareThe package and the portal’s confirmation are saved with the request
Waiting on the payerThe deadline is tracked, and the request stays on your list
ApprovedThe authorization number is recordedApproved
If a payer denies a request, the appeal letter and peer-to-peer prep are a click away.
One place for the whole request
A different checklist for every payer and procedure. CardioAuth keeps each one, and builds the request around it.
The payer’s criteria
A checklist for every procedure and payer, verified against current policies during setup.
Evidence from the chart
Notes and test reports from your EHR, filed under the criterion each one supports.
Know before you submit
An approval estimate, and anything still missing, before a request goes out.
The package, assembled
Cover sheet, letter of medical necessity and criteria crosswalk in one PDF.
Decisions and appeals
Deadlines tracked, and for a denial, the appeal letter and peer-to-peer prep.
See what’s working
Approval rates, turnaround and denial reasons, by payer and procedure.
See it in the app
Real screens from CardioAuth, with sample patients. Click or tap a screen to see it larger.
Your whole queue at a glance
Every request with its approval estimate, what it still needs and the dollars at stake.
Notes from the chart, filed for you
Notes from the EHR attach to the criterion they support, with dates checked against the payer’s time limits.
Every criterion, measured
Each criterion shows whether it’s met, and the estimate climbs as the evidence comes in.
The package, assembled
The cover sheet, the letter and the crosswalk, built from the checklist and ready for the payer’s portal.
See what’s working
Approval and denial rates, payer turnaround and revenue protected, from the decisions you record.
Payers and procedures
The national payers your patients carry, plus Blue and regional plans, for the procedures cardiology practices request most. New payers and procedures are added all the time.
National payers
Traditional Medicare
UnitedHealthcare
Aetna
Humana
Cigna
Anthem
Blue Cross Blue Shield plans
Regional plans
Blue Cross Blue Shield of Michigan
Blue Care Network
Priority Health
HAP
Michigan Medicaid plans
Imaging and stress testing
Coronary CT angiography
FFR-CT
AI plaque analysis
Cardiac MRI
SPECT perfusion
PET perfusion
Stress echo
Exercise stress test
Transthoracic echo
Transesophageal echo
Structural heart
TAVR
Mitral TEER
Left atrial appendage closure
Rhythm and devices
AF ablation
Pacemaker
ICD
CRT-D
Wearable defibrillator
Loop recorder
Holter and patch monitors
Event and telemetry monitors
Coronary
Diagnostic catheterization
Elective PCI
Cardiac rehabilitation
Vascular
Carotid duplex
Aortic and renal duplex
Venous duplex
Lower-extremity arterial studies
Medications
PCSK9 inhibitors
Inclisiran
Mavacamten
Tafamidis
Checklists start from each payer’s published criteria, and CardioAuth watches for policy changes. Missing a payer or procedure your practice needs? Tell us, and we’ll add it.
Patient information stays with your practice
CardioAuth is designed around HIPAA’s Security Rule, and we sign a business associate agreement with every practice.
Your own app and database
Each practice runs separately, so patient information is never shared between practices.
Two-step sign-in for everyone
An authenticator app on top of the password, automatic sign-out, and lockout after failed attempts.
A record of every access
Every sign-in, record viewed, change and download is logged for your administrators.
Your data, any time
Download all your requests, documents and logs as one file.
Encrypted throughout
In transit and at rest.
Plans by team size
Every plan includes everything, priced per user, and the per-user price drops as your team grows. Your first month is free.
More than 10 users? Talk to us about group pricing.
Getting started
Your first month is free, and we do the setup with you.
Your own CardioAuthSet up for your practice, with its own database.
Connect your EHRStaff sign in with their own EHR accounts.
Check your top payersWe verify the checklists you’ll use most.
Train the teamA short session, then help whenever you need it.
Go liveClear out the sample requests and start.
“Before CardioAuth, every stress test and CT authorization meant digging through the chart and guessing what the payer wanted. Now the notes are already attached when we open a request, and we know it’s complete before it goes out.”
Practice administrator Independent cardiology practice
Sample quote: shown in previews only, until it’s replaced with a real one
$999 per user per month for up to 2 users, $899 for up to 5, and $799 for up to 10, with everything included. Your first month is free. See the plans.
Which EHRs does it work with?
IMS by Meditab first, with Epic, athenahealth and eClinicalWorks on the way. Without a connected EHR, your team can still enter requests and attach notes by hand.
How long does setup take?
Your practice’s own CardioAuth can be ready the same day. Connecting your EHR depends on your EHR vendor, and we verify your top payers’ checklists and train your team during the trial.
Do we still submit through the payer’s portal?
Yes. CardioAuth prepares the complete package and links to the right portal, so nothing changes on the payer’s side.
Is patient information safe?
Each practice has its own app and database, everyone uses two-step sign-in, and every access is logged. We sign a business associate agreement with every practice.
What if a payer or procedure we need isn’t listed?
Tell us. We add payers and procedures all the time, starting with the ones our practices need.
Talk to us
Tell us about your practice, and we’ll show you CardioAuth with your own payers and procedures.