Electrophysiology Peer Review & Utilization Management

Clinical Precision
in Every Rhythm

RhythmHelp provides independent, board-certified peer review of cardiac electrophysiology cases for insurance carriers — identifying fraud, waste, and abuse with physician-grade expertise.

Explore

What We Do

RhythmHelp performs granular, data-driven review of electrophysiology ablation procedures — correlating the operative note, intracardiac electrogram tracings, and three-dimensional mapping system data to determine whether the work actually performed fulfills the CPT codes billed.

This is not a chart review. It is a technical analysis of the procedural record by a physician who performs these cases.

Every reviewed procedure is classified into one of three determinations:

Appropriately Performed & Billed The procedure was executed as described, the billing codes are supported, and the clinical approach was reasonable.
Meets Billing Requirements — Clinically Ineffective Billing codes are technically supported, but the procedural data indicates the ablation was unlikely to achieve meaningful clinical efficacy.
Not Meeting Meaningful Attempt at Clinical Efficacy The procedural record does not support that a legitimate ablation attempt was performed to the standard the billed codes require.
01

Operative Note Correlation

The dictated procedure report is cross-referenced against objective data sources to identify discrepancies between narrative and record.

02

Intracardiac Tracing Analysis

Currently supporting LabSystem™ Pro (Bard / Boston Scientific) recordings. GE and Abbott systems coming soon.

03

Mapping System Review

Currently supporting CARTO™ 3 (Johnson & Johnson MedTech). Abbott EnSite™, Boston Scientific Rhythmia™, and Medtronic systems coming soon.

04

Defensible Written Determination

A structured report with clinical rationale, supporting data references, and denial defense — built to withstand appeal.

How We Work Together

Our engagement model is designed for simplicity and scalability — from single-case reviews to enterprise-level program integration.

01
Case Files

You require the upload of operative note, recording and mapping case files to a secure HIPAA-compliant repository as a condition of payment for EP studies and ablation procedures.

02
EP Physician Review

A board-certified electrophysiologist performs a structured clinical evaluation of a selection of your paid cases.

03
Detailed Report

For cases found lacking, you receive a comprehensive, defensible written determination with clinical rationale.

04
Recovery

At your discretion, you may demand recovery of inappropriate payment for procedures not performed to the standards required by your provider agreements.

05
Ongoing Support

We remain available for peer-to-peer calls, appeals, and regulatory inquiries.

Standard Review $100 per case review

A board-certified EP physician review with a comprehensive written determination. No retainer. No subscription. No commitment required to begin.

Recovery Partnership 50 / 50 of reclaimed amounts

When a review supports reversal or partial reclamation, RhythmHelp splits the recovered amount equally — and provides full defense of the denial at no additional cost.

What This Means for
Your Bottom Line

Cardiac electrophysiology is among the highest-cost specialties in medicine. A single inappropriate ablation or device implant can represent tens of thousands of dollars in unnecessary spend.

Generalist reviewers — even experienced cardiologists — often lack the subspecialty depth to challenge EP procedural claims with confidence. RhythmHelp closes that gap.

Our reviews provide defensible, expert-level clinical opinions that withstand appeals and support your Special Investigations Unit in building cases for recovery and fraud referral.

$35K+ Average cost of a single EP ablation procedure
~15% Estimated inappropriate EP procedure rate in literature
100× Typical return on peer review investment per case

What We Require

We've designed our intake process to minimize administrative burden while ensuring we have the clinical information necessary to deliver a defensible, thorough review.

01

Business Associate Agreement

A signed BAA is required prior to transmission of any PHI. We provide our standard template or will review yours.

02

Clinical Records

Relevant records including operative reports, device interrogations, EP study data, prior authorization requests, and pertinent history.

03

State Licensure

Reviews must comply with applicable state utilization management regulations. We'll verify our ability to perform reviews for your members' states.

04

Service Agreement

A straightforward service agreement governs our engagement, covering fees, deliverables, confidentiality, and dispute resolution.

John Garner, MD, FACC — Founder, RhythmHelp LLC

Physician.
Expert. Advocate.

John Garner, MD, FACC is a board-certified cardiac electrophysiologist and the Medical Director of Electrophysiology for the CoxHealth hospital system in Springfield, Missouri — a role he has held since building the program from the ground up into a high-volume, tertiary-care EP service line serving the region.

Dr. Garner completed his cardiovascular fellowship at Baylor University Medical Center under Drs. Clyde Yancy and Rob Kowal, followed by subspecialty training in clinical cardiac electrophysiology at Indiana University School of Medicine under the legendary Dr. John Miller. He served as Chief Fellow in both programs.

His clinical practice spans the full spectrum of electrophysiology, with particular expertise in complex catheter ablation, ventricular tachycardia, and advanced device therapy. He holds active board certifications in Clinical Cardiac Electrophysiology and Cardiovascular Disease through the ABIM, and has served on the ABIM Electrophysiology Board Examination Standard Setting Group.

Dr. Garner has served as principal investigator on multiple landmark multi-center clinical trials, holds patents in cardiac arrhythmia workflow technology, and maintains appointments as Assistant Professor of Medicine at the University of Missouri School of Medicine and as clinical faculty for the US Special Operations Combat Medic training program. He has also served extensively as a medicolegal consultant for both plaintiffs and defendants in cardiac electrophysiology matters.

RhythmHelp represents the convergence of his clinical depth, his experience navigating the operational and financial realities of a major EP program, and his conviction that insurance carriers deserve the same subspecialty rigor on the review side that the operating room demands on the procedural side.

John Garner, MD, FACC
Board Certified — Clinical Cardiac Electrophysiology & Cardiovascular Disease (ABIM)
Medical Director of Electrophysiology, CoxHealth Systems
Assistant Professor of Medicine, University of Missouri School of Medicine
Founder & Medical Director, RhythmHelp LLC

Ready to Partner?

Submit an inquiry below and we'll respond within one business day to discuss your program's needs.