Medcare MSO 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

Not only is oncology one of the most rapidly developing fields of medicine, it is also among the most far-reaching, with patients of all ages and types, and practitioners in many different settings. All these factors combine to make oncology medical billing among the most complex of all the different specializations.
The codes for medical billing are updated annually, but there are also changes to regulations, government program rules and insurer requirements that may happen all through the year. Failing to incorporate each payer’s demands and the latest codes into each claim will result in non- payment—and in this economy, no one can afford to not get paid for the services they provide.
On the other hand, trying to stay on top of all the changes can take so much time and attention that it is impossible to focus on patients and providing the care they need. Outsourcing oncology revenue cycle management has become a popular solution that increases revenue while allowing medical professionals to get back to focusing on patient care.

Oncology Billing Services Take the Pressure Off Physicians

By its very nature, oncology is one of the more stressful fields of medicine. The seriousness of the conditions being treated means that physicians are frequently dealing with life-threatening diseases and complex treatments. That means anything that can be done to relieve job stress should be done.
On top of all that, rapidly changing treatment technologies mean extra work keeping up with codes, submitting claims and negotiating reimbursement rates. These are some of the things effective oncology medical billing services can take care of for you.
The staff on Medcare MSO’s oncology billing team know how to effectively respond to denials and rejections, so that no unpaid claims are abandoned. Our billing and coding procedures have been streamlined to ensure efficient processing and our staff receive ongoing training to make sure errors are not repeated. Our RCM specialists will even handle any required annual payer adjustments and payback.

Why You Should Outsource Oncology Billing to Specialists

There are many reasons oncology billing and coding is so complicated, starting with the fact that the coding system in general is complex. There’s just no way around it, you have to work with the codes, and since they change, there is no way to become an expert at billing for oncology without constantly dedicating time to it.

Get Full Appropriate Compensation

In order to get the full appropriate compensation, claims must be submitted without errors, but must also include all the necessary details, which may not be written out, but must be included in the form of numerical modifiers defined within the medical billing codes. When claims for surgeries are in the tens of thousands of dollars, it is certainly not feasible to have reimbursements delayed by a month or more while these details are ironed out. By outsourcing to professional oncology billing services, providers can get claims submitted faster with far fewer errors and issues that cause rejections and denials.

Medcare MSO Masters the Challenges of Oncology Medical Billing

There are several factors that make oncology billing especially challenging for in-house billing teams. Our state-of-the-art software is one of the keys to our high success rates, and our highly trained and experienced billing staff is another. As soon as our team takes over medical billing for a business, the number of claim rejections drops dramatically. So, what makes us so different? We recognize every client is unique and we make a point of addressing each of their needs. We also know that each area of specialization has its own set of requirements, so we make sure the assigned team is trained on them and knows what to do.
The following are some of the aspects of oncology revenue cycle management that tend to cause the most problems.

We Track Every Single Claim

Another reason to outsource your oncology billing services to Medcare MSO is that in addition to a team of our experienced medical billers being assigned to your account, we will also appoint an account manager so that there will always be someone who is familiar with your business and who knows the status of all your claims. Millions of dollars are lost by medical practices every year simply because rejected and denied claims are dropped. Medcare MSO’s account managers track every claim and make sure to follow up on anything that is unpaid, regardless of whether it is for a large amount or a small one.

Complex Procedures

Oncology is a high-tech field, and treatments often involve new equipment, extensive surgeries, radiation therapies, chemotherapy, etc. Multiple practitioners involved may be from different facilities, and the process may extend over a long period of time, all of which make billing more difficult. As an oncology medical billing company, we reduce all the complexities of the billing process.

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.

Bundled Codes

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 Medcare MSO

We Are Dedicated to Medical Billing and RCM

At Medcare MSO, 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.
Medcare MSO 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 Medcare MSO’s 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.