Oncology Medical Billing
Oncology is one of the most rapidly developing fields of medicine. Moreover, Oncology is a high-tech field and treatments involve new equipment, extensive surgeries, radiation therapies & chemotherapy. Hence, Oncology practices face various challenges such as frequent coding changes, dynamic compliance rules and payer ignorance about the latest technology.
Coding & billing for Oncology practice is complex. Billing errors such as the misuse of modifiers to identify services, treatment or improper documentation frequently lead to denial of claims.
Explore medical billing services from the Medisys Data team. Error free billing processes & transparent reporting for higher claims and faster reimbursements & more revenue. Our billing experts manage your entire revenue cycle so you can collect more revenue without doing any of the heavy lifting.
Our Revenue Cycle Services can Reduce Costs and Improve Margins
Patient insurance/eligibility verification
It’s very important to verify every patient’s eligibility and benefits to make sure that physicians receive payment for all services rendered. Medisys Data Solutions offers a comprehensive patient eligibility verification package to help physicians confirm all details about patient insurance coverage in advance (well before the patient walks in to see the physician). Our team’s focus is on avoiding denials and delays in payment. This way we can boost revenue and also improve patient satisfaction.
We are equipped with insurance eligibility verification experts who will call insurance companies and confirm the coverage, benefit options, demographic data, and prior authorization requirements for each patient for their date of service.
Payment posting & secondary billing
We pay highest attention to payment posting as this is one of the key processes in medical billing. We post electronic payments in the billing software of the client and handle the exceptions manually to make sure each payment gets posted fully. The ERAs (electronic remittance advice) are stored either in the billing software or DMS (document management system) for future reference.
All payers share an Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA) for the payment of claim. Our billing experts post received payments into the respective patient accounts in the billing software against the particular claim to balance each patient account. Rules for processing payments differ from client to client which also indicate the cut-off level to take adjustments, write-offs, refunds etc.
Once insurance payments are posted, our billers check, if there are any secondary claims that can be created and submitted, if required. Once all insurance payments have been received and account adjustments made, the remaining balance on the account is identified as patient responsibility (Co-pay, Deductible etc.) invoiced to patient accordingly.
The key to a tangible preauthorization is to provide the correct CPT code. To conclude the correct code, the biller checks with the physician to find out what the physician anticipates doing. Make sure you get all possible scenarios; otherwise, you would run in the risk of a procedure that was performed which is not covered.
Each insurance plan has their set of covered services that require pre-authorization. The burden of gaining pre-authorizations is on the provider because patients don’t have knowledge about CPT codes and may not know when pre-authorization is required. Taking an extra precaution to double check whether pre-authorization is required may take some extra time, but this process will save significant time later trying to chase down claims and payments.
Denial management and resolution
Denied claims and its management is an essential element to resolve for a healthy cash flow. We are equipped with the best medical coding and billing professionals, hand-picked for their expertise in the healthcare domain. These professionals are perpetually enrolled in continual staff education initiatives, so as to possess the most up-to-date knowledge on the billing and coding guidelines.
Leverage our systematic best practices and proven methodology to bring excellence to your revenue cycle management, including the denial management process.
Improve the health of your practice and prevent future denials with our suggestions for process improvements.
Patient demographic entry
Every single piece of patient information is vital in medical billing and coding, as this information directly impacts the insurance claims payment. You can batch the patients’ demographic data and share it with us to carry out patient demographic entry. Our experts carefully enter patient demographic data, as even the smallest of errors can lead to denials by insurance companies.
If you are finding it difficult to keep up with the patient demographic data entry with your in-house team, then outsourcing it, can be a great way to ensure successful claims processing.
You should have effective insurance model in recovering due payments from insurance carriers within a specific time frame. Consistent AR follow up helps the physicians to run practice smoothly and successfully. We ensure each client that their amount is gets refunded as soon as possible from insurance companies.
At Medisys Data Solutions, we well understand all claim denial facts and we focus to reduce the average AR follow up services process time by regularly following up the pending claims.
We utilize experienced, well-trained individuals in the medical billing process. Most of our employees have multiple years of experience in medical billing collections and coding.
Coding & Billing
Medical coding and billing is the strength of the healthcare revenue cycle; ensuring payers and patients reimburse providers for services delivered.
Timely submission of medical claims and getting reimbursements without delay is vital for successfully running the practice. Outsourcing medical billing and coding services can help you to avail error free and faster recovery at less cost. We understand the criticality of timely medical billing and coding and get you will be free from the follow-up and administrative work associated with billing and coding. This will help you focus on your core competencies such as providing quality healthcare services to patients.
Patient statement preparation
Patient statements help you reduce costs and save time by billing your patients quickly and efficiently. A delayed revenue cycle can negatively impact patient relationships and internal efficiency. Make sure your clients have everything they need to pay their bills on time.
Once the biller has received the report from the payer, it’s time to make the statement for the patient. Once the payer has agreed to pay the provider for a portion of the services on the claim, the remaining amount is passed to the patient.
The final phase of the billing process is ensuring those bills get well paid and within a specific time. Billers are in charge of mailing out timely, accurate medical bills, and then following up with patients whose bills are pending. Once the bill is paid by the patient then the information is stored in the billing software.
We have an expert coding and billing team for oncology medical billing and coding. We handle all tasks related to claims processing and keeping track of all accounts receivable. We are a HIPAA compliant organization and our clients can be sure that their data and processes are absolutely secure.