Interval billing for cardiac device management

A case study in aligning revenue capture with the patient journey

Continuous remote monitoring of cardiac implantable electronic devices has become a standard for cardiac care. Yet, in many cardiac device clinics, billing workflows are still built on legacy assumptions: that care happens as a discrete encounter on a specific day. That mismatch can create unnecessary strain for device clinics that are also trying to manage rising transmission volume, growing patient populations, and the realities of long-term remote care.

Key takeaways:

• Continuous cardiac monitoring does not align well with billing models built around one-time encounters.

• Delayed interval closeout can affect both patient follow-up cadence and reimbursement consistency.

• In two leading U.S. cardiology centers, interval-based workflows were associated with major gains in compliance, efficiency, and revenue.

Why interval timing matters

For short-term ambulatory monitoring, encounter-based billing aligns reasonably well with the service being delivered. But long-term management of implantable devices is continuous by nature. Patients may transmit multiple times during a monitoring period, and clinical review can happen across that interval rather than around one scheduled event.

When device clinics try to force this continuous reality into an encounter-based workflow, the result is often a cycle of manual tracking, delayed closeouts, and work that does not cleanly translate into reimbursement aligned with the care provided.

To solve this, Murj® designs software that shifts the device clinic’s organizing framework from the schedule to the monitoring period itself. By automating the tracking of these intervals, technology helps ensure that clinical actions and billing readiness stay perfectly in sync. As Todd Butka, CEO of Murj, explains:

“What has really shifted in care and remote monitoring is it is no longer based on a schedule. It is based on a period of time, or what we think about as interval-based care.”

Without this shift, the closeout of one interval often depends on manual steps or physician review timing. When those steps lag, the next interval slips. Over time, these “micro-delays” aggregate into significant operational drift, reducing consistency in both patient follow-up and revenue capture.

As programs grow and data volume increases, managing remote monitoring as an interval of care becomes the only scalable way to maintain continuity. Having a system that reflects this reality is no longer a luxury—it is a requirement for the modern device clinic.What the results look like in practice

Recent findings from two leading U.S. cardiology centers illustrate the impact of this new approach to billing.

In both cardiology centers, moving to interval-based workflows was associated with compliance improving from well below target levels to above 90%. Those changes were accompanied by stronger operational consistency, more sustainable workflows, and measurable financial improvement.

One center, after modernizing workflows across a large multi-site environment, sustained compliance above 90% while supporting continued patient growth. The other saw a substantial revenue lift over time, with gains tied not simply to higher volume, but to more consistent interval tracking, workflow streamlining and billing automation.

That distinction matters. The opportunity is not just to do more work. It is to create a model that is better aligned with how remote monitoring is actually delivered.

The bigger takeaway

Continuous cardiac monitoring cannot be managed like a one-time event. Cardiac device clinics are managing an ongoing flow of patient information across a population while maintaining continuity of care, operational consistency, and the processes that support reimbursement. As remote monitoring programs continue to expand, the device clinics best positioned for long-term success will be the ones whose workflows and billing models reflect the continuous nature of the care they deliver.

See how Murj automates interval-based care for its clients:

• Read the full case study for a closer look at the workflow changes, performance gains, and operational lessons behind these results.

• Listen to Todd Butka, Murj CEO, on the recent Becker’s Healthcare Podcast discussing what the shift beyond episodic models means for workflow and care delivery.

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