Denial Management

Compliance with radiation therapy billing guidelines is essential for accurate and optimized reimbursement. PRO meets the challenge of compliance with all requisite billing guidelines from HIPAA, Medicare and Medicaid, private insurance companies. As billing guidelines change, we update our system with automated rules and edits to ensure that your practice is always up-to-date.

We have optimized the billing process specifically for a radiation oncology practice, consistently reducing administrative costs and increasing revenue. Our proven practice optimization solutions are designed for your practice in conjunction with your system. We deploy a denial management program, and specific software tools combined with a highly skilled team of professionals. We will ensure that all treatment components are properly coded and entered into our proprietary billing system.

The Practice Revenue Optimization System

PRO understands that keeping up with the demands of a constantly-changing healthcare system is crucial to survival. Our billing services reduce the burden of revenue management, freeing up staff resources to focus on what you do best: provide excellent clinical care. Our system bills electronically with all major commercial insurers and Medicare and Medicaid. It provides claims submission management, ensuring that all claims are verified before being submitted, and reimbursement management, which will significantly reduce your percentage of denied or underpaid claims. Our specialists will work with carriers to investigate potential underpayments and ensure that all radiation therapy billing is resolved swiftly and satisfactorily.

PRO covers the spectrum of Modalities

PRO has experience in working with all current modalities in use today, including IMRT, IGRT, SRS, SBRT, Brachytherapy and other radiation therapy programs. Our flexible billing solutions can be customized to meet the needs of your practice and specialty.

We have experience with billing the following radiation oncology modalities:

•  External Beam Radiation
•  3-D Conformal Radiotherapy
•  Gamma Knife Treatments
•  Brachytherapy Prostate Seed Implants
•  Image Guided Radiation Therapy (IGRT)
•  Intraoperative Radiation Therapy (IORT)
•  Intensity Modulated Radiation Therapy (IMRT)
•  Specialty Areas:  Breast, Brain, Prostate, Lung