What we handle for oncology practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Chemotherapy administration
Infusion and injection administration billed to documented start and stop times with correct hierarchy.
Drug billing
J-codes billed to the exact units administered, with documented waste from single-dose vials.
Radiation oncology
Treatment planning, simulation and delivery billed across the course of treatment.
Prior authorisation
Regimens tracked against approved authorisations before treatment is delivered.
Where oncology claims usually go wrong
These are the four issues we see most often when we take over a oncology practice.
J-code unit errors
Units are defined per drug, not per vial. A unit error on a biologic can be thousands of dollars in either direction.
Documented waste
Discarded drug from single-dose vials is billable with modifier JW and documentation. Unbilled waste is pure loss.
Administration hierarchy
Only one initial administration code per encounter. Sequencing errors deny the whole set.
Authorisation for regimen changes
A change in regimen usually needs a new authorisation. Treating first is uncompensated care.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Oncology billing questions
Something not covered here? Call (833) 305-5528.
Do you handle drug waste billing?
Yes, with modifier JW and the documentation payers require.
Can you manage prior authorisations for chemotherapy?
We track them and flag renewals and regimen changes before treatment.
Do you bill radiation oncology?
Yes, including planning, simulation and delivery codes.