ONCOLOGY MEDICAL BILLING SERVICES
METACARE provides specialized oncology billing services to ensure that submitted claims are in compliance with government policies and that our clients receive maximum reimbursements. We also offer a full suite of medical revenue cycle management (RCM) services.
Why It Makes Sense to Outsource Oncology Medical Billing
Oncology medical billing is undeniably one of the most complex and challenging areas of medical billing. The rapidly evolving nature of the field, the diverse patient population, and the various practice settings all contribute to the complexity of oncology billing.
The codes for medical billing are updated annually, and there are also frequent changes to regulations, government program rules, and insurer requirements throughout the year. Staying on top of all these changes and incorporating each payer’s demands and the latest codes into every claim is a daunting task. Failure to do so can result in non-payment, which can have serious financial implications for oncology practices.
Oncology Billing Services Take the Pressure Off Physicians
In the high-stress field of oncology, anything that can be done to relieve the burden on physicians should be a priority. Dealing with life-threatening diseases and complex treatments can be emotionally taxing, so finding support to alleviate administrative tasks is crucial.
The rapidly evolving landscape of oncology treatment technologies demands constant efforts to keep up with codes, claims submission, and reimbursement negotiations. Effective oncology medical billing services can play a pivotal role in managing these complexities, allowing healthcare providers to focus on patient care.
Get Full Appropriate Compensation
In oncology medical billing, the accurate inclusion of all necessary details, including numerical modifiers defined within the medical billing codes, is essential to ensure full and appropriate compensation. Failing to include these critical details can result in delayed reimbursements, claim rejections, and denials, leading to significant financial challenges for healthcare providers.
For high-value claims, such as those for surgeries that cost tens of thousands of dollars, any delay in reimbursement can have a substantial impact on a practice’s financial health. It is crucial to streamline the billing process and ensure that claims are submitted promptly and accurately.
We Track Every Single Claim
One of the compelling reasons to outsource oncology billing services to METACARE is the personalized attention and support offered through dedicated account managers. In addition to a team of experienced medical billers working on your account, having an assigned account manager ensures that there is always someone familiar with your business and the status of all your claims.
Having a dedicated account manager offers several significant benefits. Firstly, they provide a single point of contact for all billing-related inquiries and concerns, streamlining communication and enhancing efficiency. They are well-versed in your practice’s unique needs and can address any specific requirements promptly.
Complex Procedures
Oncology is a high-tech and complex field of medicine, with treatments that often involve state-of-the-art equipment, extensive surgeries, radiation therapies, chemotherapy, and more. The involvement of multiple practitioners from different facilities and the long duration of treatment further compound the billing challenges.
Multi-Disciplinary Teams
Treatment of cancer is rarely as simple as a tumor removal. More likely, there will be a series of treatments, often involving specialists from other medical disciplines, from plastic surgeons to hepatologists. Because each person’s role must be accounted for in the coding, and they may represent different business entities as well as medical disciplines, coding must be detailed to present all the necessary information.
Complex Procedures
Because so many oncology procedures are complex, involving many parts and people, but the process is similar for each patient, there has been an effort to simplify billing by “bundling” the charges into a single code so that one bill is submitted to the payer instead of many smaller ones. Oncology procedures frequently require some variation from the exact set of services in the bundle, so an oncology medical billing company must know what exactly is included in the bundle and how to code for any variances. Even something as simple as a change to the expected anesthetic can cause the entire claim for a surgery to be denied. This means coders and billers must know what is included in the bundle and be aware of any additional services given that need to be billed separately. That kind of familiarity comes with experience, so the billing team needs to include a senior biller who knows what to look for to avoid common pitfalls.
While it may seem like the right thing to do would be just to add codes for extras like an additional day of hospitalization or the use of a different anesthetic, this would result in claim denials because it would be seen as a duplication without the correct notation in the coding.
Under-Coding Violations
Under-coding, or failing to charge for all services delivered, is clearly a way to lose money, but it is also illegal. While it may seem like simply doing a favor for the patient who may be facing an overwhelming bill already, it is important to follow the requirements of the law and report all services. Under-coding can cause your oncology practice to lose your status as a credentialed provider, among other consequences.
Oncology Billing High-Level, High-Cost Services
In a medical field where a physician sees many patients daily for simple exams, one lost claim won’t result in a huge drain on the practice’s billing and revenue, but oncology generally involves more detailed, higher cost services, so losing a single claim can be a large loss of revenue. It is imperative that an oncology billing company has the experience to recognize any potential problems and get them rectified swiftly.
Increase Revenue and Reduce Administrative Stress by Outsourcing Oncology Billing to METACARE
Our innovative hepatology billing solutions include proprietary software to make coding simple and assure that all the latest changes are included. We also can take care of payer credentialing and annual payback and compliance reviews.
We Are Dedicated to Medical Billing and RCM
At METACARE, we are dedicated to getting our clients the maximum reimbursements allowable. Claims are filed as soon as possible (typically within 48 hours). Whenever any kind of pattern is observed in reimbursement denials, we make sure the responsible biller gets corrected so the error stops, and we train the team on that detail, so that no one else makes the same mistake. METACARE is dedicated only to medical billing and RCM, with a large, experienced oncology revenue cycle management staff. Our innovative approach and proprietary software have proven to increase revenue and leave our clients feeling much more enthused about practicing medicine because they can go back to focusing on patient care, knowing that their revenue management is in good hands.
Full Medical RCM Services for Oncology Practices
We have the expertise to handle all your medical revenue cycle management needs, including payer credentialing, insurer approvals, billing and coding (including swift and expert management of denials and rejections) chart reviews, annual pay back, and much more; however, our services are fully customized to meet the unique needs of each client, so you aren’t required to pay for anything you don’t want. Many of METACARE clients that start out using our medical billing services find they get so much benefit from working with us that they choose to add on additional RCM services. To find out more about our billing services for oncology practices, give us a call at 800-640-6409 or get a free demo today. We look forward to showing you how we can relieve the administrative burden of medical billing and increase your revenue, allowing you to devote your attention to your patients.