As an oncology provider, delivering high-quality clinical care to your patients is of the utmost importance, and equally significant is providing top-notch financial care for your patients. Collaborating with a specialized oncology billing service is crucial for the financial care of patients and your practice. This partnership ensures that claim submissions and any subsequent actions taken on your patients’ behalf are not only accurate but are also carried out with compassion and understanding. In this article, we will explore the distinctive advantages of engaging with an oncology billing company and guide the key considerations when selecting an oncology billing service before committing to a contract.
What are the benefits of partnering with an oncology billing company?
Numerous billing companies may have a general understanding of coding and billing practices, but it’s vital to recognize that cancer care and its reimbursement procedures come with unique nuances that set them apart from other areas of healthcare specialties. Just as your patients prefer a cancer specialist to oversee their case instead of a general practitioner, it is equally important for you to collaborate with a company that specializes in assisting oncology practices by offering expert, oncology-specific financial care. This approach helps alleviate unnecessary stress and concern for your patients.
Thorough knowledge of oncology-related procedure codes and modifiers.
Cancer care is a highly intricate field. Treatment plans or regimens often involve a combination of various therapies to target and eliminate the cancer cells thoroughly. These can include surgery, chemotherapy, immunotherapy, and radiation therapy. Given the complexity, a billing specialist who lacks in-depth knowledge of these nuances could easily make mistakes that lead to denials and cause delays for reimbursement or eliminate reimbursement if timely accurate corrections are not made per coding guidelines. RC Billing’s specialists are well-versed in the intricacies of codes and coding guidelines related to oncology. Their specialized knowledge and experience are invaluable in ensuring accurate and timely reimbursement for your practice.
Experience navigating payer requirements for cancer diagnosis and care
Cancer treatment can quickly become costly and insurance coverage may not encompass all associated expenses. Additionally, medical, surgical, and radiation oncology services often require prior authorization for the overall treatment plan or specific procedures within the plan. To provide the best financial care for patients during this challenging time – emotionally, physically, and financially – it’s crucial to verify the patient’s insurance eligibility and coverage amounts according to the physician’s prescribed treatment plan.
This allows you to identify potential out-of-pocket costs that the patient will be responsible for before commencing treatment, affording the opportunity to provide quality financial care for the patient by discussing their financial responsibility with them. This minimizes the chances of unexpected costs for patients and ensures compliance with the No Surprise Act, benefiting your practice and your patients.
Moreover, relying on oncology billing specialists ensures that you are delivering quality financial care to your patients and reduces the risk of regulatory violations that could lead to fines, penalties, and audits for your practice. This specialized expertise enhances both the patient experience and the financial stability of your oncology practice.
More time and resources to focus on what matters
Coordinating billing for cancer care services involves numerous complex elements. Oncology billing companies are well-equipped with established systems and workflows to ensure the efficient synchronization of these elements. Timely reimbursement is vital for maintaining the full operational capacity of your facility. Our oncology billing company provides the expertise and efficiency needed to accurately enter charges and submit complete, accurate claims to insurance companies promptly.
By outsourcing these tasks, your staff can redirect their time and energy towards the core mission of ensuring your patients receive compassionate, high-quality clinical care, instead of being occupied with chasing down reimbursement. This allows your team to focus on what truly matters: the well-being of your patients.
Things to consider when choosing an oncology billing partner
It’s essential to verify the certifications held by a billing company to ensure they meet the necessary standards and compliance requirements. For instance, RC Billing undergoes an annual SSAE 18 SOC 1 Type 2 Audit, a separate Risk Assessment, and is fully certified as HIPAA compliant. This certification assures potential partners that their financial and patient data is securely handled and that the company adheres to rigorous policies and procedures. Assessing these credentials provides the peace of mind that you are engaging with a knowledgeable and trustworthy organization that takes data security and compliance seriously.
Many oncology practices choose to partner with an external billing service primarily because of their expertise. Managing billing in-house is an option but requires securing staffing, management oversight, and providing oncology-specific training and education to your team internally. Relying on a billing company that specializes in oncology is based on the belief that their team possesses the specialized experience needed to optimize the revenue cycle for your practice, all while eliminating the burden of handling staffing and training internally.
The transition to electronic healthcare records (EHR) and billing processes has become standard practice. Many healthcare providers, like your practice, rely on EHR systems for record-keeping. When collaborating with a billing company, it’s crucial that their billing software can seamlessly integrate with your EHR system through an HL7 interface.
If you find yourself having to overhaul your record-keeping system to accommodate the billing company’s software, it may not be the most suitable fit for your practice. A seamless integration ensures a more efficient and streamlined workflow, benefiting both your practice and the billing company, and ultimately, your patients.
Transparency and Communication
Access to complete and accurate financial records is indispensable for any business, including healthcare providers. When partnering with an oncology billing company, they gain access to a significant portion of your essential financial data, such as procedure analysis, reimbursement summaries, and accounts receivable reporting. Therefore, it is crucial to have a clear understanding of the systems and processes they have in place for sharing this information with you, the level of detail in their procedures, their financial reporting capabilities, and the ease of access to this data.
RC Billing provides its clients with comprehensive financial reports every month, in addition to weekly charge and collection reports. What sets us apart is that our clients can access this data at any time, allowing them to enhance profitability and efficiency and make well-informed financial decisions. This accessibility and transparency are vital for the successful financial management of your practice.
What makes RC Billing different?
With a history of over three decades focusing exclusively on oncology and a clientele of 350+ physicians nationwide, RC Billing has effectively managed tens of billions of dollars in claims for oncology practices. Our specialization not only safeguards against revenue loss but also optimizes patient financial care, operational efficiency, and profitability. Our comprehensive service package covers a wide range of services, starting with physician credentialing and payer contracting, and extending to the day-to-day billing operations including demographic and charge entry, claims submission, denial resolution to include payer claim denial appeals, patient statements, coding resources, and specialized medical record documentation review to ensure your documentation complies with all regulations.
We encourage you to complete a contact form to explore our service and discover how we can create a valuable partnership with your practice.