Components & challenges of Radiation-Oncology billing
Cancer being among the most common ailments in the US, radiation oncology is one of the most used medical services in the US with care providers of all types (independent practitioners to hospitals) involved in it. This means a sizable amount of medical resources (money and medical effort) spent on healthcare in the US is claimed by radiation oncology. Alas, most part of it goes unrealized given the demanding nature of insurance procedures.
The radiation oncology insurance procedure involves patient registering, charge entry, claim generation and transmission, payment posting, making appeals for denials and incorrect claims and collection management – and electronic submission of claims to be HIPPA compliant.
Unfortunately, successful reimbursement of a radiation oncology episode requires more than careful adherence to policies, accurate handling of details and ability to transfer data electronically, it also needs:
- Thorough understanding of how much coverage Medicare plan entitles you to (there are three of them Plan A, B and C)
- Establishing whether the oncology treatment was medically necessary and recommended by a licensed physician
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