CMS regulatory and coding changes, revenue cycle management (RCM) complexities, compliance issues and reimbursement cuts are forcing oncologists to streamline their billing and administrative tasks. In comparison to other medical specialties, denied claims for oncology practices require a more effective denial management solution.

The administrative and financial pressures have increased for this medical specialty due to the 2010 Affordable Care Act. Since new technology implementations and radiation treatments have become more complex, oncologists are facing difficulties in overcoming their revenue challenges.

How Effective is an In-house Billing Team?

In order to survive in the business, collection of payments at the time of patent visits has become essential for private practices. As most of the physicians are short of time due to patient influx and increased documentation, maintaining an in-house billing team has become a daunting task.

Oncologists are facing troubles in hiring and training coders well-versed in ICD-9 and ICD-10, purchasing expensive billing software and other systems, and monitoring the progress of the billing department on a regular basis. Due to these challenges, they are finding it beneficial to outsource the task of revenue cycle management to a reliable third party. Billing companies have the necessary resources to help specialties including oncology to meet challenges related to billing and administration.

Outsourcing and Streamlining Billing and Administration

The efficiency of medical billing and coding process determines the financial performance of a practice. To overcome reimbursement challenges, many oncologists are outsourcing their RCM needs to a billing company. By seeking assistance from a team of skilled and certified coders and billing experts, they have been able to streamline clinical and administrative tasks.

Why is Outsourcing an Effective Option?

Billing companies like have specialists well-versed in ICD-9 and ICD-10 coding. They are trained in using new and revised codes for radiation oncology procedures, diagnostic, nuclear and interventional procedures. For instance, two new CPT codes were added in radiation oncology 32701 and 0301T in 2013. Same year, CPT codes 77373 and 77418 suffered with a 15% cut. This cut was due to the reduction in procedure time for these treatments.

Billing companies like MBC ensure accuracy in assigning codes for the latest radiation oncology procedures. Oncologists can get timely payment for rendered services as MBC’s dedicated team handles coding, claims submission, HIPAA compliance, denial management, appeals and various other revenue cycle tasks.

Considering the payment cuts and stringent healthcare reforms, it has become important for oncologists to have a billing team that is aware of coding changes and other aspects related to radiation oncology billing. Not just accuracy in coding but also following the timeline for claims submission is equally important for getting paid. Billing companies are focused on processing medical insurance claims within minimal time so that oncologists get maximum reimbursement.

A reputed billing company hires ICD-10 trained coders which eliminates the need for oncologists to hire and train coders or make expensive system changes. From patient enrolment and insurance verifications to coding, billing and AR collections, every important aspect of oncology medical billing is handled by billing companies.

Published By - Medical Billers and Coders
Published Date - Nov-04-2014 Back

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