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Radiation Oncology Billing Services California, CA

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

Running a medical practice in California can be quite challenging when it comes to medical billing and coding. Our billers and coders in all the major cities of California including Los Angeles, San Diego, San Jose, San Francisco, Fresno can help you settle your requirements here are some of the services which our expert medical billers and coders specializes in:

  • Tracking and follow-up on unpaid claims
  • Preparing Patient statements and payment posting
  • Customizing billing reports for better control
  • Primary and secondary insurance claims filing

Value Our California Billers Bring:

Our medical billers and coders are not limited to just the big cities such as Fresno, San Francisco, and San Diego but also all other smaller cities and towns in California. Moreover our billers are compliant with HIPAA guidelines and are updated with all industry updates through medicalbillerandcoder.com. This makes sure that your practice is run in the most efficient and legally safe conditions. Our Billing specialists also ensure that your patients are hassle free and their billing queries are answered well.

The expertise of our billers is vast and includes but is not limited to Past Due Collections, Electronic Medical claim filing, Medicare Audit Protection, coding and diagnosis analysis for maximum allowable reimbursement, customized accounts receivable and revenue cycle financial analysis, electronic claims submissions, denials management and payment posting, dedicated and relentless insurance follow-up, patient statements and patient-centric support, provider enrollment support, and standardized reporting.

Our Specialties:

Our medical billing specialists are committed to improving your productivity by utilizing finest processes and health care information technology such as Electronic Medical Records. These medical billers and coders maximize your revenue, ensure timely compensation, and offer medical billing and coding services in specialties including Family Practice, mental health , pain management, Physical Therapy, radiology, Internal Medicine, neurology, orthopedic, and numerous other areas.

Our Software Experience:

The fact that physician shortage is set to quadruple in the next decade according to AAMC (Association of American Medical Colleges) makes it vital that physicians utilize professional and accurate medical billing and coding services. The various software that we provide in addition to the value added services mentioned above ensures that physicians are capable of keeping up-to-date with the healthcare IT sector reforms and improvements. Some of the medical coding and billing software that our billers have experience on include Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges California physicians Face:

The most common challenges faced by physicians in big cities such as San Jose and Los Angeles are underperforming accounts receivables or collections and claims denial. Both these situations along with other errors may lead to decreased revenue. Our billers provide the solutions to these problems by making the denial management efficient and offering services such as integrated medical billing with EMR along with numerous other value added services like sending patient statements and processing refunds to Medicare in order to preserve your practice from RAC audits.

As a physician in California, it becomes difficult to keep track of all the changes taking place in the legislation related to your practice. This is where the expertise and experience of our medical billing specialists can be of immense help. It almost seems that payers are in the business of claim denial and can afford to make mistakes at your expense. Although the new HIPAA guidelines would ensure a smoother process, the amount of patient-doctor encounters would increase in the future making it difficult to extract time for coding, billing, claim denial and compliance with HIPAA regulations. Specialized medical billers and coders such as ours can ensure that your practice not only flourishes but is also HIPAA compliant.

Needless to say, this leaves individual physicians, physician groups, clinics, diagnostic facilities, long term care facilities and acute care facilities with unrealized payments (ARs) and consequently ailing revenues.

Outsourcing to MBC:

MBC’s billers and coders possess a comprehensive knowledge of radiation oncology billing and coding procedures. Our years of experience in handling intricacies of radiation therapy billing and coding procedures translates into a very sophisticated level of understanding of the diseases involved in radiation therapy versus the insurance procedures applicable to them.

We have been able to bring down claim denial rates for care providers across all the state of the US through accurate handling of data and rigorous follow-ups done in a methodical manner. Our quality consciousness is responsible for reduction in claim denials. Both during and after preparation of claims, we put them through various cycles of quality checks to make sure that they are completely error free when submitted.

Our service models are flexible, so that you can choose a model that perfectly fits your needs and setup. We offer two types of models:

  • RCM consulting
  • Outsourcing

Our consulting model involves a thorough study of your revenue management system to help identify areas of revenue leakage, outdated software applications and training needs. By helping you address these areas our RCM service will ensure a smooth revenue management process capable of handling the dynamics of radiation therapy insurance requirements and reduced rejected claims.

However, if you don’t have an in-house billing and coding team, you can ship out your entire billing and coding responsibilities to MBC. Our outsourcing model includes the entire range of billing and coding activities starting from identifying insurance eligibility of the patient to submission of claims and post submission follow-ups.

We provide services across all phases of claim preparation and submission:

  • Charge Entry : Our Charge Entry (CE) services ensure error free claim submission through verification of patient demographics, medical codes, DOS, POS, provider information, units, modifiers as also submission of claims to clearing houses and more. CE also involves random quality checks as part of audits.
  • Payment Posting : Our billers and coders can work on the most advanced electronic remittance scenarios, including denials, underpayments, overpayments, multiple adjustments, automatic cross-over, secondary remittance, reversals, etc.
  • Account Receivable : We reduce your claim rejection rates and ensure a timely payment of your services by following up with insurance officials ensuring that you enjoy improved revenues.

Medicalbillersandcoders.com is a national network with our team spread across all states of the US with each state represented by billers and coders familiar with state-specific exceptions. This helps us to account for the fact that the rules applicable across the US are not uniform. MBC has helped care providers across US to improve their revenues as well as quality of radiation oncology treatment by allowing them to concentrate on their core services.