Prime Doc Billing provides oncology Revenue Cycle Management (RCM) services for oncology practices across all 50 U.S. states. Our RCM services include each step, from patient registration and charge capture to reimbursement and reporting.
Our oncology billing specialists manage medical billing, claims processing, denial management, payment posting, and accounts receivable follow-up to optimize financial performance, increase revenue collection, reduce claim denials, accelerate reimbursements, and improve cash flow for oncology providers.
Our Specialties
All the stages of revenue cycle are included in our oncology revenue cycle management services, like:
Oncology practices often work with multiple payers and facilities which requires them to be enrolled with Medicare, Medicaid and commercial insurance companies. Prime Doc Billing ensures the oncologists are credentialed to avoid claim rejections.
Our oncology credentialing experts ensure the oncologists are completely authorized to bill for oncology consultations, chemotherapy and radiation therapy.
Oncology or cancer care requires definite coding because of the advanced drug administrations and treatments. Our oncology coding specialists manage and apply accurate J codes for high cost oncology drugs.
Prime Doc Billing complies with NCCI (National Correct Coding Initiative) edits and payer-specific oncology coding guidelines to minimize audit risks.
Oncology treatments are relatively expensive, making oncology claims high-value. Prime Doc Billing handles oncology claim submission with extreme precision for chemo, radiation, and labs. Our oncology billing specialists track daily claim status monitoring and proactively follow-up on the pending claims for faster payments.
Authorization issues and drug coding errors in oncology often cause claim denials. Prime Doc Billing performs root cause analysis of oncology denials and appeals for chemo and radiation claims to avoid any delay in cancer care.
We work on prevention strategies alongside denial management to minimize repeated denials and protect oncology practice’s revenue.
Prime Doc Billing manages the entire oncology RCM services including:
Prime Doc Billing provides revenue cycle management services for all the medically necessary oncology procedures, including:
By outsourcing RCM services, healthcare providers get access to experienced billing professionals and scalable solutions to enhance revenue cycle efficiency of the practice. Oncology providers often face unique RCM challenges because of the billing and coding complexity of cancer care procedures, like chemotherapy, immunotherapy, radiation therapy, and infusion services while staying compliant with the payer specific guidelines.
Outsourcing oncology revenue cycle management helps practices overcome the challenges by getting access to specialists with expertise in oncology billing and reimbursement. Outsourced billing companies proactively identify and resolve claim denials, submit timely appeals, and maintain compliance with oncology-specific industry regulations.
Outsourcing oncology revenue cycle management helps practices improve financial performance while reducing administrative burden from the internal teams. Experienced outsourcing teams track outstanding oncology payments, handle denial follow-ups, and identify revenue leakage to keep the cash flow uninterrupted.
You should choose Prime Doc Billing for outsourcing oncology RCM services because of our in-depth understanding of oncology billing complexity, and our experienced RCM team, which includes oncology rcm specialists, billing specialists, and certified coders with expertise in:
Prime Doc Billing’s process of oncology medical billing includes:
We collect patient demographics and insurance details to verify eligibility and coverage of oncology services beforehand. Our oncology billing team identifies co-pays and deductibles before the start of cancer treatment.
Prime Doc Billing records all the oncology-related services like radiation therapy, chemotherapy, and infusions to ensure proper documentation. Accurate charge capture helps avoid missed charges for oncology practices.
Our oncology medical coding experts apply accurate CPT, ICD-10, and HCPCS codes for oncology treatments and complex therapies. We use modifiers for same-day procedures or multiple treatments to avoid confusions and minimize coding errors.
Our oncology billing analysts review infusion records, physician notes, and cancer treatment plans. Reviewing oncology records ensures all oncology documentation meets payer-specific guidelines.
Prime Doc Billing’s oncology billing specialists obtain approvals for chemotherapy, radiation and high-cost medications beforehand. We track authorizations in real-time to prevent any delay in cancer care.
We submit claims accurately and monitor claim status for denials, delays, or rejections. Our oncology billing analysts follow up with the payers to secure timely reimbursements and prevent delays in oncology treatment.
Our oncology AR specialists generate patient statements and post insurance payments to reduce billing confusion. We ensure transparency to promote clear financial communication.
We analyze denial trends and identify the root cause of repeated denials. Our oncology denial management experts implement preventive strategies to reduce recurring denials.
Frequently Asked Questions
Oncology medical billing is a process of managing and submitting insurance claims for cancer care. Oncology billing includes accurate coding, claim submission, accounts receivable and denial management.
Oncology billing guidelines include following payer-specific guidelines along with the proper use of CPT, ICD-10, and HCPCS codes for chemo, radiation, and immunotherapy. Oncology billing guidelines ensure maximum reimbursement for cancer care provided to the patients.
The most common CPT codes used in oncology medical billing are:
Chemotherapy and infusion administration (96401-96549)
Chemotherapy infusion duration (96413-96415)
Radiation therapy and planning (77385-77499)
Following are some of the common endocrinology modifiers:
HCPCS codes used in oncology medical billing often includes:
ICD-10 codes for oncology billing services include:
Some of the common modifiers used in oncology billing are:
The best oncology billing software in the US is Kareo which is primarily designed for small practices and operates on a cloud-based platform.
What Healthcare Providers Say About Us?
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(347) 650-2656
(347) 650-2656
info@primedocbilling.com
