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Posted on May 12, 2026

Heartbase Virtual User Conference 2026

Join us June 16–18 for the 2026 heartbase Virtual User Conference. Designed for clinicians, coders, and cardiovascular teams, the conference will feature product training, upcoming enhancements, workflow tips, and real-world insights from heartbase users and partners. Learn how to get even more value from solutions like hbCOR and hbRecon while staying up to date on what’s ahead.

This complimentary online event is open to all heartbase users and invited guests. Register below to reserve your spot! Please note, you will need to register for each conference day, not by session.

Register here: https://heartbase.zendesk.com/hc/en-us/articles/45322914557581-2026-Heartbase-Virtual-User-Conference-Schedule-Register-Here

If you are unable to access your Knowledgebase account, please contact Sophia Gawrit (Sophiagawrit@heartbase.net) to ensure your account is properly provisioned.

Interested in attending but not currently a heartbase client? Please reach out to Sophia Gawrit (Sophiagawrit@heartbase.net) for additional information.

Posted on April 1, 2026

hbRecon Success Demonstrated in JACC Case Report

JACC Case Reports Volume 30, Number 36 features an exciting article that shows how Chandler Regional Medical Center used heartbase’s hbRecon toolkit to correct documentation issues around heart failure, improve the accuracy of patient acuity, and recoup six-figure revenue over a six-month period.

Congratulations to the article authors, Omar Rizvi, Rachel M. Bond, Kerry A. Webb, Angelina R.R. Erwin, Jessica Parsons, and Dan Inder S. Sraow!

For more information, read the full article on the JACC website here: Click Here

Project Summary

A multidisciplinary team implemented a standardized form, tracking processes using a third-party registry vendor tool (hbCOR and hbRecon), and weekly/monthly reviews. This intervention significantly increased the accurate capture of heart failure and Medicare Severity Diagnosis Related Group 266 coding, resulting in an estimated $414K revenue increase over 6-month time frame and improved preprocedural risk evaluation, demonstrating that simple coding and documentation practices can substantially enhance both financial and clinical outcomes

Posted on March 25, 2026

Building a Stronger heartbase, Part 3: hbAnalytics + hbRecon

a female healthcare professional sitting at a desk and typing on a laptop

CV programs generate a tremendous amount of data. Collecting, analyzing, and ultimately acting on that data is what separates the programs that succeed from those that struggle. For many leading CV programs across the country, heartbase is the key to more successfully managing and leveraging their clinical and financial data.

Between hbCOR, hbNote, and hbAnalytics, heartbase offers innovative solutions for every side of the data equation—and they work even better together. hbRecon is the key to delivering even stronger results for your program’s clinical insights and financial goals.

Part 1 of this blog series covered how hbCOR and hbRecon make collecting and acting on your CV data simple. Part 2 showed how hbNote and hbRecon help CV programs get ahead of costly coding mistakes. Here in Part 3, we’ll show how hbRecon works toward the same goal as hbAnalytics, heartbase’s solution for real-time clinical and financial dashboards.

hbAnalytics: Meaningful Metrics for Real-Time Insights

Even if your program has mastered the art of capturing CV data, many run into the same issue: what does it all mean, and what do you do with it?

hbAnalytics is purpose-built to help CV programs see the full picture of their data and understand the path forward. By merging clinical and financial reporting, hbAnalytics gives clinicians and hospitals the real-time insights they need to strengthen their research, improve patient care, and reduce costs.

The metrics that matter: hbAnalytics consolidates clinical or merged clinical and financial data to easily compare performance by various parameters across your network, divisions or regions, facilities, and providers with patient-level drillthrough.
Visual dashboards: Simply visualize your CV datasets with dynamic graphs, benchmarks, metric performances, contribution margins, COE goals, and more. hbAnalytics supports STS and ACC-NCDR dashboards, with multiple channels of distribution.
Custom reports: Quickly and easily generate custom reports with graphical renderings, and automatically distribute them to authorized users. Optionally integrating clinical registry data with coding and financial data enables reporting on a variety of financial parameters, providing deeper insight into your bottom line.

hbRecon: CV Data Alignment for More Accurate Revenue

Clinicians and coding teams don’t always see eye to eye. Whether it’s unclear clinical documentation or missing information entirely, the data that’s passed between the clinical side of your business and the coding side can leave critical and costly information on the cutting room floor. That misalignment can have six-figure repercussions for your revenue.

hbRecon helps CV programs overcome alignment discrepancies and ensure that the clinician’s insights and documentation are captured and represented on the coding side. By extrapolating your CV registry data, hbRecon suggests an appropriate medical billing code (MS DRG, ICD-10, CPT, HCPCS, CDM) for the procedure that accurately reflects the services provided and the patient’s conditions, securing the appropriate reimbursement.

A single source of truth: Clinical registry, coding, and financial datasets often exist in siloes. hbRecon brings those disparate datasets together side by side in a single intuitive interface. This approach uncovers potential documentation gaps that would otherwise leave major revenue on the table.
Clinician and coder collaboration: Clinicians aren’t taught to code. Likewise, coders aren’t versed in the clinical nuances of CV procedures. hbRecon acts as a translator, giving both teams a shared platform to voice their needs and do their jobs efficiently.
Streamline operations: When the speed bumps on the path to revenue are paved flat, a stronger bottom line often follows. Many leading CV programs use the revenue unlocked with hbRecon to invest in their teams, equipment, and overall operations.

hbAnalytics + hbRecon: Deeper Insights for Informed Improvements

When clinical and financial data work together, CV programs can truly achieve more. While they operate as separate platforms, hbAnalytics and hbRecon use overlapping data sources to offer thorough insights of your program’s performance, both clinically and financially.

This holistic approach provides immediate feedback on the measures that deliver the greatest impact on patient care and your bottom line. Many of heartbase’s clients leverage those insights to demonstrate the success of their CV programs and communicate opportunities for improvement.

“That’s why you collect the data: to improve outcomes for the patients in your community,” shares Karen G. McNickle, RN, MSN, former Manager of Cardiovascular Services, Data and Quality at one of heartbase’s hospital clients. “hbRecon helps us accurately document the severity of our patients’ illnesses and receive appropriate financial compensation to pour back into improving our CV program.”

Through coding reconciliation and rebilling with hbRecon and process improvements with hbAnalytics, hospitals that employ a unified heartbase workflow more easily identify areas of opportunity for their CV programs.

“hbAnalytics provides us with real-time dashboards we can use to audit our data and distribute scorecards to help reach our performance goals. The Center of Excellence dashboards allow us to set internal benchmarks and to identify hospital and network performance on priority outcomes and other important metrics, delivering actionable insights from a governed, single source of truth.”

-Jerod Weimer, Bakersfield Memorial Hospital

Build a Stronger heartbase Workflow Today

Throughout this blog series, you’ve learned how hbRecon unlocks the full potential of the unified heartbase workflow with hbCOR, hbNote, and hbAnalytics. Together, heartbase has helped CV programs master their data and make significant improvements in operations, patient outcomes, and revenue capture.

Let’s put our heads together and see how hbRecon, hbAnalytics, and the rest of the heartbase suite can move your CV program forward.

Request Demo

Posted on January 12, 2026

Building a Stronger heartbase, Part 2: hbNote + hbRecon

A doctor sits at a desk reviewing information on a tablet in a modern office with a monitor showing X-rays.

There’s a reason why heartbase is the heart of leading CV programs across the nation. Heartbase solutions, such as hbCOR, hbNote, and hbAnalytics, provide critical automation to streamline CV workflows, built-in compliance tools to meet regulatory requirements, and powerful interoperability to reveal meaningful financial and clinical insights.

While each heartbase solution was designed to bring substantial value on its own, they work even better together. hbRecon helps unlock the full potential of your unified heartbase workflow to deliver even deeper insights and revenue opportunities.

In Part 1 of this blog series, we showed how hbCOR and hbRecon work together to deliver more accurate data and actionable insights for your bottom line. Here in Part 2, we’ll explore how hbRecon brings out the full potential of hbNote, heartbase’s solution for data-first structured reporting.

hbNote: Simpler Reporting, Easier Compliance

Structured Reporting (SR) is critical to CV success, but many solutions on the market leave discrepancies between the coding & patient records and the physician’s final report. That gap doesn’t just complicate the paper trail; it can expose your CV program to real risk during an audit.

hbNote is a data-first approach to SR. By automatically generating narrative reports through an innovative side-by-side data collection workspace, hbNote minimizes registry and other clinical data collection and ensures that the physician’s final report always aligns with the coding & patient records.

Automation and ease of use. As data is entered, hbNote automatically renders an export-ready narrative report in real time. Providers can add additional text via keyboard or popular dictation software like Dragon Medical One. An interactive coronary tree is also available to note grafts and stenosis values, giving users a single, simple interface to generate comprehensive reports with ease.
Advanced customization. While hbNote offers standardized interfaces and templates for each procedure, they can be easily customized to user- and site-specific needs. Providers can adjust templates on the fly, adding sections, paragraphs, dynamic tables, and other styles and formatting options.
Built for compliance. hbNote’s templates and workflows adhere to the Health Policy Statement for structured reporting for the Cardiac Catheterization Lab and IHE Cardiac Procedure note (CPN). This consideration supports common registry goals and maximizes compliance to MACRA and MIPS.
Billing and coding integration. Based on the clinical data elements collected, hbNote generates recommended CPT, ICD-10, HCPCS, and MS-DRG codes, ensuring that the correct language is used to maximize reimbursement.

hbRecon: Clinical and Coding Data, Unified

Many CV programs don’t realize that they’re leaving major revenue on the table. The truth is that there are six-figure billing opportunities being missed constantly, and it all comes down to a language barrier between clinicians and coders. Without cross-communication, nuances about a CV procedure, like complications and comorbidities, are easily missed on the coding side. What’s harder to miss is the impact it can have on your cash flow.

hbRecon is a purpose-built solution for coding reconciliation and revenue capture. It analyzes your CV data to suggest an appropriate MS-DRG code for each procedure, making sure those costly nuances are recognized, coded, and ultimately billed appropriately.

One interface for more accurate billing. By consolidating clinical registry, coding, and financial datasets in one intuitive interface, hbRecon makes it easier for coders to uncover costly gaps in CV procedure documentation. Coders can view all relevant data side by side and identify costly discrepancies before they impact your bottom line.
Clinicians and coders, aligning at last. Say goodbye to the silo. hbRecon provides a platform for cross-departmental collaboration between clinicians and coders. With shared meetings, emails, and monthly workbooks, both sides can voice their needs to streamline the data handoff.
The foundation for operational efficiency. Raises, bonuses, adopting new equipment—it’s all possible when your bottom line is stronger. However you choose to move your CV program forward, it’s easier when you unlock accurate cash flow with hbRecon.

hbNote + hbRecon: Greater Consistency, A Greater Safety Net for Your CV Program

No matter what side of the equation you look at, nothing trips up a CV program like data mismatches. When there’s a disconnect between what’s being documented on the patient record, the narrative report, and the eventual coding and billing of the procedure, it can cause costly stumbles in both compliance and potential revenue.

As a standalone solution, hbNote connects the dots between the clinical registry and other clinical data sources. This connection ensures that there’s always alignment between the physician’s final report, coding & billing (through coding recommendations), and the patient record.

Meanwhile, hbRecon ensures that all coding/billing opportunities are filed timely as additional clinical registry data is collected which hbNote may not account for, such as procedures that are documented in other software or dictated.

“hbRecon brings us full circle,” explains Beth Kennalley, RN, MSN, a Data Coordinator with one of hbRecon’s major hospital clients. “We see the original finding, which stays visible as clinicians and coders continue to add their own findings. That approach allows us to go back and forth to discuss changes.”

Kennalley continues, “At the end of the process, we can all see the exact information that goes to billing. The collaboration helps us make changes and improve our performance over time. It’s been a big win for us.”

hbNote is an invaluable tool to push those changes and improvements forward. Thanks to its flexibility and customization, providers can easily adjust their narrative reports to include any additional information requested by your coding team, ensuring data is billed correctly without necessitating a rebill. These adjustments can be saved to heartbase’s hbNote resource library for easy access in the future, so collecting that helpful additional data becomes part of your clinical team’s standard operating procedure.

A Stronger heartbase Workflow Starts Here

Don’t let data mismatches trip you up. A unified heartbase workflow based on hbNote and hbRecon can boost the integrity and actionability of your data to move your CV program forward. Let’s put a personalized demo on your calendar, and you’ll see how your heartbase workflow can do even more with hbNote and hbRecon.

Request Demo

Posted on December 10, 2025

Heartbase, Inc., Certified in STS General Thoracic Surgery Database v5.26.1

CHICAGO, IL – We are excited to announce that heartbase™ is officially certified by the STS for the General Thoracic Surgery Database v5.26.1. On January 8th, 2026, at 2:30 pm CT, heartbase clinical specialist Carmen Ernst, RN, BSN, will hold a special training class covering the ins and outs of this version. Heartbase customers can click here to register.

From the STS website:

The STS General Thoracic Surgery Database (GTSD) is the largest and most robust clinical thoracic surgical database in North America. The GTSD contains nearly 800,000 general thoracic surgery procedure records and currently has more than 900 participating surgeons.”

Participation offers:

Integration & Interoperability with other heartbase hbCOR registry events.
Interoperability options from other hospital systems, such as Epic Clarity, to allow for the pre-population of discrete fields.
A comprehensively streamlined & customizable electronic DCF, improving upon the flow and functionality of the STS Online Tool, with options such as role-based access.
Simplified reporting with the hbQuery Tool, with measure reporting and other standard reports to follow.
Integration with the hbRecon Module to ensure GTSD cases are correctly coded and billed, maximizing reimbursement.
Planned hbAnalytics updates to include new dashboards and associated breakout reports.

If you’re an STS data manager or abstractor and would like to take a look at our new forms, please contact heartbase Director of Client Accounts Alex Potanos to schedule a review session.

About heartbase, Inc.

Heartbase™ is a privately-held company founded in 1992 and designed to be intuitive & centered on the needs of the clinician. Since our inception, we have known that the most effective way to develop a robust and reflexive software platform is through collegial partnerships with our clinical & financial users. Working directly with our customers – listening to their concerns and honoring their suggestions for improvement – allows us to build a tool that is fast, efficient, and tailored specifically to the individual needs of each healthcare institution.

Posted on November 18, 2025

Building a Stronger heartbase, Part 1: hbCOR + hbRecon

A woman in blue scrubs is speaking on the phone, appearing engaged in a conversation.

For leading cardiovascular programs across the U.S., their custom heartbase workflow is a driver of success across the board. heartbase solutions like hbCOR, hbNote, and hbAnalytics streamline workflows, unearth actionable data, and unlock greater insights into the financial and clinical performance of their program.

Each heartbase solution was designed to have a powerful impact in a key area of cardiovascular (CV) data capture, reporting, and analytics. They work seamlessly together with hbRecon as the connective tissue that helps programs like yours do more with their data.

Follow along throughout this blog series, where we’ll explore how hbRecon works together with other heartbase solutions to unlock greater outcomes for your CV program. In Part 1, we’re covering how hbRecon is a perfect partner for hbCOR, heartbase’s solution for streamlined CV data collection.

hbCOR: Data Capture Made Simple

Every year, clinical data sets become increasingly complex. CV programs find themselves juggling more registry requirements than ever across various systems, and capturing it all can feel like a Herculean task—not to mention ensuring that the data is accurate and reliable.

hbCOR is the easier way to capture CV data. With support for submission and collection from every major CV registry, hbCOR arms your team with standardized, validated data they can trust at every step. Check out the features that are included with hbCOR below:

hbAudit: Data validation & pre-harvest checks. hbCOR’s hbAudit feature validates CV data as it is entered in real time, automatically flagging any entries that look incomplete or out of the ordinary. When it’s time for submission, hbCOR runs a pre-harvest check to ensure 100% accuracy before the data is passed downstream.
hbReporting & hbQuery: Pre-generated report templates & ad hoc reporting. hbCOR’s hbReporting feature houses an extensive library of clinically meaningful reports that the average user can run without any special knowledge. With hbQuery, clinical staff can easily generate reports on demand and access all clinical data points for a patient population over a specified time period.
hbInteroperability: Integrate clinical data from various IT sources. Between EMR, hemodynamics systems, billing software, and other sources, it can be tricky for CV programs to manage all of the data at their fingertips. hbCOR’s hbInteroperability feature automatically pre-populates data from these disparate sources, cutting down on the burden of data abstraction.

hbRecon: CV Data and Coding Reconciliation

When CV clinical and coding datasets are not aligned, there’s six-figure revenue at stake—and it happens in CV programs across the country more often than you might realize. Clinical documentation often lacks the required specificity that coders need to appropriately code CV procedures, especially complications and comorbidities, leaving major reimbursement opportunities on the table.

hbRecon breaks down this costly barrier and helps clinicians and coders find alignment. Extrapolating your CV data allows hbRecon to recommend an appropriate MS-DRG code for the procedure, leading to more accurate revenue capture.

Clinical registry, coding, and financial datasets in one place. hbRecon consolidates all of the data needed for accurate billing, uncovering potential gaps in documentation. This thorough process reduces underbilling and overbilling by flagging discrepancies between clinical data and coding.
Cross-departmental collaboration. Clinicians and coders are often siloed, with neither having visibility into the other. heartbase facilitates communication between these two departments through monthly workbooks, emails, and meetings, to ensure both sides understand what the other needs to do their job efficiently.
Institutional enhancements. More accurate revenue often leads to a fortified bottom line, which many leaders reinvest in their CV programs. hbRecon is the first step toward hiring new staff, giving raises and bonuses, investing in new equipment, and other ways to move your program forward.

hbCOR + hbRecon: More Accurate Data, More Actionable Outcomes for Your Bottom Line

When data is reliable and accurate, your CV program’s bottom line flourishes. That’s the reality for the leading CV programs that lean on hbCOR paired with hbRecon.

On its own, hbCOR’s extensive data cleanup tools ensure that your CV registry is as accurate as possible from the earliest stages. When hbRecon is brought into the picture, it serves as a final audit, then uses that accurate registry data to correct and improve coding—and thus, your program’s ability to capture more accurate revenue.

Many heartbase customers use that improved revenue to justify improvements to their CV program. Take it from Kerry Webb, MBA, BSN, RN, an RN CV Quality Data Analyst at a healthcare network with more than 40 hospitals and care centers across the U.S.

“hbRecon has given us a different language to speak to our physicians and our stakeholders,” she shares. “We can talk in dollars and cents, so we can show the impact our program has on patient care. Getting new equipment, hiring the top talent, taking care of our people—it’s all on the table when we’re armed with data hbRecon gives us.”

hbCOR paired with hbRecon ensures that your registry and coding data are always in alignment—a critical factor in the event of a CMS audit. From boosting your bottom line to safeguarding your compliance, the combined hbCOR + hbRecon workflow is a winning combination for CV programs.

Unlock a Stronger heartbase Workflow

With hbCOR and hbRecon working together as part of a unified heartbase workflow, CV programs can rely on trustworthy, actionable data to impact their bottom line. Schedule your personalized demo to see how a heartbase workflow based on hbCOR and hbRecon can help your CV program flourish.

Request Demo

Posted on July 10, 2025

Strengthening CV Outcomes with Merged Clinical & Coding Data – from Registry Submission to Revenue Capture

A doctor typing on a laptop, focused on their work in a clinical setting.

Reliable clinical registry data management is at the heart of any cardiovascular program. While collecting data through abstraction and reports and integrating it with coding can feel like a well-oiled machine, many leading cardiovascular programs are unaware of a gap that could be costing them six-figure revenue.

The gap? Clinical registry data and coding teams often speak different languages.

hbRecon: Opening the Door for More Accurate CV Coding

hbRecon, a complement to hbCOR, bridges that gap. It translates clinical data into a specific and actionable coding format to identify a DRG code that more accurately captures the nature of the care provided.

Here’s how hbRecon integrates into your existing heartbase workflow:

Data integration. hbRecon integrates data in its custom platform to create a unified dataset. This includes integrating clinical data with hospital coding and financial information to accurately reflect the care provided.
Report generation and review. heartbase provides feedback and insight on a weekly basis and presents a wide array of reports, from DRG Summary Reports to ICD-10 Procedure & Diagnoses Detail Reports.
Reconciliation and process review. This step gives the clinical team a chance to review the cases and submit them for secondary review by the hospital coding and compliance teams, if needed. This process varies site-by-site, but its four primary objectives are:

Reviewing documentation and coding
Re-coding and re-billing as indicated
Identifying outliers with complex coding
Reabstracting clinical data, as necessary

Following this integration, your clinical data will “speak the same language” as your coding team to capture revenue more accurately than ever before. The implications for your CV program’s bottom line can’t be understated.

hbCOR: A Solid Foundation for CV Data Collection

Of course, a strong clinical registry data management system starts with a solid foundation. hbRecon is most effective when paired with hbCOR’s ability to unify clinical data from every major CV registry. Using a single comprehensive repository, clinical teams can easily access a complete picture of a patient’s cardiovascular history.

With hbCOR, the following CV Registries are all in one convenient location:

The American College of Cardiology NCDR (ACC-NCDR)
The Society of Thoracic Surgeons Database (STS)
The American Heart Association Get With The Guidelines (AHA GWTG)
Extracorporeal Life Support Organization (ELSO-ECMO)
State Registries (CCORP, COAP, IHA, and more)
Custom Registries

Additional benefits include:

Simplified data collection: Reduce the burden of manual data collection with hbCOR’s advanced interoperability.
Real-time data validation: Leverage immediate pre-harvest data validation for completeness, accuracy, and compliance.
On-Demand Reports & Scorecards: Access the following reports and scorecards.
- Ad Hoc Queries
- MD Scorecards
- Complications & Outcomes Reporting
- Equipment Analysis
- AUC & Risk Scoring
- and more!

With the partnership between hbRecon and hbCOR in place, many leading CV programs turn data into actionable insights that boost financial performance, including improvements in the Case Mix Index (CMI).

Improved Financial Outcomes from CV Data Collection

While hbCOR and hbRecon can be employed independently, this iterative work between the two platforms – available in one seamless heartbase workflow – can have a profound impact on your cardiovascular program’s bottom line. By facilitating more accurate data transfer between clinical registry and coding, the addition of hbRecon helps CV programs with:

Reduction in overbilling and underbilling: hbRecon runs real-time data analysis to identify and rectify coding discrepancies. That leads to more precise DRG assignments that reduce over- and under-billing.
Improved reimbursement rates: Integrating clinical registry data and coding with hbRecon results in more accurately reflected episodes of care. The result is reimbursements that are commensurate with the care provided, which isn’t always a given.
Consistent performance improvement: Clinical registry data-based audits deliver actionable insights that build momentum for cross-departmental initiatives focused on addressing specific challenges, ultimately leading to efficiencies that save costs.

See hbRecon in action and discover how it captures six-figure revenue.

Download Case Study

You’ve already built the foundation for better CV data management with hbCOR. Schedule a demo to discover how integrating hbRecon can make your data more accurate and actionable to transform your CV program’s revenue capture.

Posted on June 16, 2025

Heartbase, Inc. Certified in ACC-NCDR LAAO v1.4

CHICAGO, IL – As of June 10th, 2025, we are excited to announce that heartbase™ is officially certified by the ACC-NCDR for Version 1.4 of the LAAO Registry Database.

On July 23rd, 2025, at 12:00 pm CT, heartbase clinical specialist Carmen Ernst, RN, BSN, will hold a special training class covering the ins and outs of this registry module. Heartbase customers can click here to register. Heartbase staff highly recommends that hbCOR users attend this session or view the recording.

For customers wanting to learn more about this module, Alex Potanos will host a general information session on June 27th at 3 pm CT as part of the heartbase Virtual User Conference. Please click here to register.

From the ACC-NCDR website:

“Get the support you need to ensure quality patient care for your atrial fibrillation patients with the American College of Cardiology’s LAAO Registry™.

Join the first national registry capturing data on left atrial appendage occlusion procedures to assess real-world procedural outcomes, short and long-term safety, comparative effectiveness and cost effectiveness. LAAO provides a treatment option to manage stroke risk for non-valvular atrial fibrillation patients who are unable to maintain adequate anticoagulation through medication therapy.”

Participation offers:

The LAAO Registry is approved by the Centers for Medicare and Medicaid Services (CMS) to meet the registry requirements outlined in the national coverage decisions for Percutaneous Left Atrial Appendage Closure.
Integration & Interoperability with other heartbase hbCOR registry events.
Interoperability options from other hospital systems, such as Epic Clarity, allow for the pre-population of discrete fields.
A comprehensively streamlined & customizable electronic DCF, improving upon the flow and functionality of the ACC Online Tool, with options such as role-based access.
Simplified reporting with the hbQuery Tool, with measure reporting and other standard reports to follow.
Integration with the hbRecon Module to ensure LAAO procedures and associated MCCs are correctly coded and billed, maximizing reimbursement to MS-DRG 273, 274, & 317.
Planned hbAnalytics updates to include new measure reporting and associated breakout reports.

About heartbase, Inc.

Our primary major business lines are the following: hbCOR, Data Capture & Reporting; hbAnalytics, Realtime Clinical & Financial Dashboards; hbRecon, Coding Reconciliation & Revenue Generation; & hbNote, Data First Structured Reporting.

Posted on February 20, 2025

It’s All About Collaboration: The Transformative Power of Clinical Registry Data-Based Audits

In cardiovascular (CV) services, and today’s healthcare landscape as a whole, achieving seamless collaboration across departments is a necessity. Unfortunately, many healthcare organizations struggle with structural & data silos, inconsistent communication, and disjointed processes – this heavily impacts their ability to streamline coding data. Outsourcing coding audits to a trusted partner not only provides a powerful solution to these challenges, but it facilitates compliance, higher quality healthcare, and invaluable interdepartmental collaboration.

Before an Audit: The Challenges

Inconsistencies Impede Ability to Hit Quality Benchmarks

Quality clinical registry benchmarks provide CV services with a method to compare performance to other similar providers and identify areas of improvement. By obtaining consistent & accurate coding data, healthcare organizations can ensure alignment between these two datasets and reduce reporting errors from systems that rely on coding data. This, in turn, leads to more informed changes rooted in evidence-based care. Unfortunately, without a clinical registry data-based audit performed in partnership with a trusted CV data partner, many organizations face significant roadblocks that stand in the way of collaboration and quality improvement efforts, such as:

Data Silos: Tracking data in silos across teams leads to inconsistencies in data reporting and makes it challenging to gain a unified view of patient outcomes and system-wide performance.

Inconsistent Quality Metrics: Inconsistent metric tracking across various departments can lead to confusion and misaligned priorities, hampering the ability to identify and address system-wide CV trends that need intervention.

Fragmented Communication: While a coder who has worked with the same provider for many years may understand shorthand or abbreviations, confusing notes and ineligible provider handwriting can still make it difficult for coders to decipher a provider’s EMR notes. Because many coders likely find it uncomfortable to approach a busy provider to ask for clarification on a specific note, coders may try to guess what the provider meant. Unfortunately, that usually results in more work long term. A clinical documentation improvement (CDI) process, or program, may help minimize these errors by checking coding data for an accurate reflection of the patient’s condition. By engaging in this exercise, practices proactively address any mistakes that may stand in the way of proper reimbursement.

Missed Opportunities for Improvement: Healthcare organizations rely on coding data to inform performance improvement and maintain quality benchmarks. In the absence of robust clinical registry-driven data analysis and reporting, it’s more challenging to make informed decisions about improving care processes, which can negatively impact patient outcomes and financial performance.

Coder Turnover: Coders not only experience a steep learning curve, but they must keep up with constantly evolving payer requirements. High turnover in the field only makes it more difficult for departments to keep up with these changes and avoid denials. Furthermore, there are 11,000 CPT codes for coders to learn, 225 new codes added in 2023, 75 deleted, and 93 revised. In fact, anesthesia represented the only section of the coding guidelines the American Medical Association didn’t change that year.¹

After an Audit: The Benefits

Data-Driven Decision-Making Leads to Actionable Insights

Organizations that introduce clinical registry data-based audits with hbRecon experience more clarity, structure, and accountability – primarily driven by our tool’s intense focus on interdepartmental collaboration. In fact, after an audit using hbRecon’s three-phased approach rooted in integration, investigation, and reconciliation, many CV practices experience the following advantages:

Reliable, Centralized Data: One of the most valuable outputs of an audit with hbRecon is the consolidation of data from disparate systems into one single platform. This allows all departments to access consistent information, eliminates discrepancies, and enables unified decision-making.

Crystal Clear Accountability and Transparency: The hbRecon audit involves developing standardized metrics that support comprehensive reporting. This enables departments to clearly see how their contributions impact overall outcomes and builds a sense of shared responsibility.

Matching Goals and Priorities: Rather than making sense of disparate goals and priorities, the audit process brings departments together to establish common quality benchmarks and objectives that set everyone on the same path toward the same goals.

Uplevel Communication Channels: hbRecon fosters cross-departmental communication between clinical and coding teams, fostering a more collaborative environment built in proactive and effective dialogue that is open and constructive so issues can be addressed before they escalate.

Consistent Quality Improvement: Clinical registry data-based audits deliver actionable insights that build momentum for cross-departmental initiatives focused on addressing specific challenges.

Seamless Collaboration: By weaving clinical registry data-based audits into the fabric of organizations, departments learn to trust one another and work together seamlessly, creating lasting partnerships that extend beyond the scope of the audit.

While clinical registry data-based audits provide outsized benefits in terms of compliance, they are also catalysts for cross-departmental collaboration and long-term improvement. In today’s complex healthcare environment, a trusted CV data partner can be the difference between hitting quality benchmarks or falling short.

Given the collaborative nature of our clinical registry data-based audits, we inherently help CV teams build transparency, alignment, and communication around coding data. But the results of these types of audits don’t stop at hitting quality benchmarks – they produce a culture that benefits patients and your bottom line.

It’s all about collaboration.

References:

HFMA. Common coding challenges hospitals face and how to fix them. HFMA. Published August 7, 2023. https://www.hfma.org/revenue-cycle/coding/common-coding-challenges-hospitals-face-and-how-to-fix-them/

Posted on January 22, 2025

Coding Audits in Cardiovascular Care: Why Claims Data Isn’t Enough

Accurate revenue capture is crucial to protecting your bottom line, improving financial performance, and reducing the risks of audits and penalties. Most importantly, it informs strategic decision-making around pricing, investments, and resource allocation that drives future profitability of cardiology services and revenue cycle optimization. While claims data has traditionally been the method of choice for coding audits, relying solely on claims data for comprehensive coding audits brings several limitations.

Limitations of Claims Data in Healthcare Audits
Claims data comes from the information healthcare providers submit to insurance companies for reimbursement. Each data source includes details about procedures performed, diagnoses, medical prescriptions, and associated costs.

However, there are limitations to relying solely on claims data for revenue capture, primarily rooted in the following coding quality issues that many cardiovascular providers face today¹:

Difficulties Keeping Pace with Changing Payer Requirements: Health insurers continually update and change coding requirements. For example, a new guideline for implanting a pacemaker may suddenly become available, and if the coding team isn’t up-to-date on the latest requirements, the claim could be denied.
Challenges Managing Coding Complexity: The range of CPT codes for cardiovascular procedures ranges from minimally invasive to complex surgical, and The American Medical Association changes CPT codes every year.¹ It’s important to consistently revisit codes to ensure accurate coding and limit denials.
Unclear Communication with Providers: Illegible handwriting or hard-to-decipher notes in EMRs make it difficult for coders.¹ Coding can be further muddied by inputs from multiple providers, as well as physician notes lacking in clinical detail.
Poor Provider Coding Education: Providers may not fully understand the importance of accurate coding to the organization’s financial bottom line, making it crucial to educate providers on the necessity of using accurate codes and communicating with coders.¹
Privacy: Patient privacy protections may limit the amount of information that can be included in claims data and – as a result – difficult to rely on claims data for revenue insights.
High Turnover for Medical Coders: In 2023, coders took the lead as the most difficult group to hire in the billing office.²Managing high staff turnover and the associated learning curves only exacerbate coders’ already challenging jobs of tracking changing payer requirements, coding complexity, and learning provider communication styles.

Revenue and Compliance Issues as a Result of Coding Gaps

Coding gaps can produce several revenue and compliance issues, including:

Overbilling: Overbilling, a revenue and compliance issue, may happen when a coder accidentally uses multiple codes instead of a single code for a procedure, potentially putting themselves at risk for insurance fraud.³hbRecon reduces overbilling through its ability to identify plausible miscoded DRGs and maximize procedure coding with higher or lower-weighted DRG codes where appropriate.

Missed Reimbursement Opportunities: A service, procedure, or condition (a CC or MCC) during a patient encounter being left out of a claim due to a missing code or skewed data can lead to a loss in revenue. hbRecon’s phased approach to integrating clinical registry and claims data results in increased reimbursement driven by identified factors in clinical registry data.

Faulty Re-Bill Processes: Faulty rebilling occurs when a claim is rebilled due to a medical or coding error. In Phase 3 of the hbRecon integration – reconciliation and process review – cases are reviewed by the clinical team and then submitted for secondary review by the hospital coding and compliance teams. This process will vary from site to site and network to network, but one of the primary objectives of this is to recode and re-bill as indicated by the findings.

The Importance of Comprehensive Medical Coding Audits for Heart Care

These challenges with claims data collection due to coding gaps, and subsequent pitfalls in revenue and compliance, point to the necessity of undergoing comprehensive coding audits that can successfully identify coding gaps in cardiovascular care and address them to support revenue cycle optimization.

However, claims audits focused on financial data inherently miss the other side of the coin – clinical registry data.

hbRecon maximizes accurate revenue capture through the integration of hospital clinical registry & coding data sources. Through this integration, hbRecon can identify cases where coding may be incorrect and identify thousands of dollars in services per case that would have otherwise gone unbilled. With claims data, if conditions are not coded, such as Acute Heart Failure, it is not possible to identify them. With clinical registry data and hbRecon, we can extrapolate those values, maximizing the revenue capture.⁴

Because clinical registry data uses discrete data elements that contain detailed clinical information about patients, diagnoses, procedures, and outcomes, and claims data uses a coded data source that includes details about procedures performed, diagnoses, medications prescribed, and associated costs, hbRecon provides a more comprehensive and accurate assessment of healthcare quality, outcomes, and financial performance. The hbRecon platform then employs an algorithm to determine a recommended DRG code using this combined dataset.

The higher levels of specificity produced by hbRecon lead to improved revenue capture through more accurate documentation and coding through education and process-improvements; enhanced quality and efficiency of care delivery; and a better reflection of patient acuity, all of which benefit the cardiovascular population.

hbRecon: The Combined Impact of Combining Clinical Registry Data with Claims Data

hbRecon’s integrated approach to coding audits is a valuable tool for increasing revenue capture as it relies on both the discrete data elements found in clinical registry data as well as the coded data sources found in claims data.

Is your healthcare organization ready to discover alternate revenue streams through the hbRecon toolkit? Our platform can integrate clinical registry and coding data sources to algorithmically analyze and determine recommended billing codes and identify probable coding mismatches and rebilling opportunities.

Schedule a discovery call today: https://www.heartbase.net/social-discovery-call

Sources

1. Conifer Health Solutions. (2023, August 7). Common coding challenges hospitals face and how to fix them. Healthcare Financial Management Association. https://www.hfma.org/revenue-cycle/coding/common-coding-challenges-hospitals-face-and-how-to-fix-them/

2. MGMA. (2023, March 23). Bottom line impacts from revenue cycle staffing challenges. MGMA. https://www.mgma.com/mgma-stats/bottom-line-impacts-from-revenue-cycle-staffing-challenges

3. Physicians Revenue Group. (2024, August 26). What is Unbundling in Medical Billing? | PRGMD. Physicians Revenue Group. https://prgmd.com/what-is-unbundling-in-medical-billing/

4. Enhancing CC and MCC Code Capture: Three Real-World Scenarios for Maximizing Reimbursement Revenue. (2024, November 25). heartbase. https://www.heartbase.net/news/2024/11/25/enhancing-cc-and-mcc-code-capture-three-real-world-scenarios-for-maximizing-reimbursement-revenue/