Adapting to evolving trends and billing practices in oncology medical billing

End to End Medical Billing Solutions
Call now 888-357-3226 (Toll Free)
http://www.medicalbillersandcoders.com
www.medicalbillersandcoders.com
Copyright ©-2013 MBC. All Rights Reserved.
Page 1 of 6
Adapting to Evolving Trends and Billing Practices in
Oncology Medical Billing
Dental medicine is often seen as a highly profitable healthcare stream with guaranteed
long term returns. However, what most people fail to understand is the amount of
complex planning and execution that goes into acquiring and maintaining that sustained
level of profitability. Dental reimbursement rates are generally poorer than medical
reimbursement rates. Given that, ensuring continual claim settlement and reduced
claim rejection requires a dental medical practitioner to focus on final details of dental
billing. Whether your dental medical billing is in-house or outsourced, there are certain
steps that you can take to ensure improved medical insurance reimbursement ratio –

Page 2 of 6
 Billing for specific modalities are more frequent than others and therefore
coding changes in them are most crucial for oncology medical billing. These
modalities include EBRT or External Beam Radio Therapy (EBRT), IMRT and non-
IMRT, SBRT or Stereotactic Body Radio, Therapy BT or Brachy-therapy and PT or
Proton therapy.
 There has been a consistent rise in billing of IMRT and other radiation therapies
since the introduction of their separate codes in early 2000s. Despite being
expensive, these are preferred procedures and Medicare, Medicaid or other
private insurance carriers process the claims for radiation therapy at a fast rate.
 Payer restrictions on oncology drugs are increasing due to abuse related audits
and many oncologists are facing high rate of payer denials for medical billing
services of oncology drugs. Medical insurance carriers are growing increasingly

Page 3 of 6
cautious about reimbursing oncology drugs claims and therefore the denial ratio
is mounting.
 Oncology practitioners are outsourcing chemotherapy coding and billing.
Chemotherapy and non-chemotherapy infusion, in addition to radiotherapy is
coded with great care and is also the biggest source of revenue for an Oncology
practitioner. Therefore, as a rising trend, this coding and billing practice is getting
outsourced to capture frequent changes and avoid any discrepancies.
 Ignorance of payers towards technological advancements and changes in
oncology treatments makes oncology medical billing an even more difficult task
for oncology practitioners and practice managers. This means clarity in claim
filing and updating your payer about technological requirements becomes part
of your responsibility as a claimant.

Page 4 of 6
 Commonly recognized oncology medical billing errors include misuse of
modifiers in service identification and improper documentation related to
treatment conducted. These lead to frequent denials and can only be checked by
adopting stringent billing practices.
 Pre-authorization requisite for cancer treatments is frequently being mandated
by insurance carriers for them to expeditiously complete the claim settlement
process. Radiation, oncology drugs and chemo/non-chemo infusions are
especially to be pre-authorized by insurers before the oncology practitioners can
administer and claim for the same.
Medicalbillersandcoders.com is a billing service provider that specializes in oncology
billing and chemotherapy or radiotherapy coding. Our team of oncology coders and

Page 5 of 6
billers handle multiple chemotherapy administrations, code bundling and therapeutic
infusion or injection reporting. Medicalbillersandcoders.com not only offers billing
solutions that can enhance your profitability but can also improve your clinical
experience and administrative performance. With a billing expert like
medicabillersandcoders.com on board, you can focus on the care to be provided instead
of administrative and financial aspects of cancer care.

Page 6 of 6
Related Posts:
 Improving Medical Insurance Reimbursement Ratio of Your Dental Medical
Billing for Sustained Profitability
 Adopting Dental Cross Medical Coding for Maximum Reimbursement of Bills
 Streamlined Dental Billing Solution Essential for Timely Reimbursement
 Stay Ahead in the Competition with Specialized Dental Billing Services
 Has Implementing EHR Benefitted Medical Billing Processes?

Adapting to evolving trends and billing practices in oncology medical billing

Recomendados

Recomendados

Mais conteúdo relacionado

Mais de Medical Billers and Coders

Mais de Medical Billers and Coders (20)

Último

Último (18)

Adapting to evolving trends and billing practices in oncology medical billing