Medical Billing is all about creating a scenario where the healthcare providers can focus on their main job of treating patients and leave the administrative part to a third party. The process of medical billing is to submit and follow up on the claims which are with the health insurance companies and receive payment for services rendered by the doctor. The same process is used for most insurance companies, be it private entities or government undertakings.

Industry Overview

The U.S. Census Bureau estimates the U.S. healthcare industry spends $2.7 trillion currently. Hospital care alone accounts for a huge portion amounting to $831.5 billion with projections to grow to $1.1 trillion by 2016.

The outsourced revenue cycle management (RCM) services are worth five billion US dollars presently, with projections predicted to reach the figure of nine by 2015; which is a 14.6% Compound Annual Growth Rate (CAGR).

Providers have seen an increase of about 5.3% in their revenue by outsourcing the administrative tasks to medical billing companies.

Medical Oncology Billing

Oncology billing involves a lot of aspects like expensive drugs, chemotherapy / non-chemotherapy infusions, hydration, etc. In such scenario it is essential to bill accurately and on time; errors in this case can lead to expensive ramifications.

Many a times providers under-code their services fearing penalty for over-coding. Sloppy billing practices too can adversely affect the income of a practice. Oncological services are long and expensive, that is why it is imperative that providers pass on the RCM services to an expert who can bill correctly and collect the revenue with minimal denials. There are several medical billing companies who specialize in this process.

Why Specialty Billing Experts?

The reason Oncology practitioners need to trust specialty billing experts is because they ensure correct units and hours of treatment are billed. By outsourcing the medical billing process they are handing over the task to a team of specialized professionals who strive to collect the money from the payer in the least possible days.

  • Medical Billing companies are experienced in managing this back end work and have a streamlined to take care of your billing needs In a scenario where co-insurance or deductibles are involved, the outsourcing billing partners provide the amount per daily treatment that should be collected
  • They regularly update the costs, carrier reimbursement schedule and monitor the weekly changes so that you come to know whether you are losing or increasing your revenue opportunities
  • They verify the diagnosis with the coders before submitting the claims to insurance companies. They also confirm if the treatment or the drugs require Pre-Certification, Pre-Determination or Specialty pharmacy requirements


The fact is medical billing is a confusing, complicated and an ever changing process. With you have a devoted team that stays up to date on the latest requirements and do everything it takes to get you paid. They troubleshoot, follow the rules and bureaucracy of insurance companies, and take out time to explain the bills to the patients as well as physicians in form of the EOB, i.e. explanation of benefits. With their best practices at work for your business, you collect more revenue at a lower cost and get paid faster.

Published By - Medical Billers and Coders
Published Date - Sep-01-2014 Back

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