Medical Billing Guidelines

Reimbursement for treatment services rendered is critical for the survival of radiation oncology practices. But without compliance to radiation oncology billing guidelines, payment may be denied or severely delayed. Consistent, competent revenue cycle management is key to a practice’s long term success.

Oncology Billing Guidelines

While each carrier you work with will have their own radiation oncology billing guidelines, there are universal guidelines as well, like the Health Insurance Portability and Accountability Act (HIPAA) and HHS’ Office of Inspector General guidelines. Medicare billing processes are in place for handling patient demographic entry, charge entry and Current Procedural Terminology and International Statistical Classification of Diseases and Related Health Problems (ICD) or ICD-9 coding.  These Medicare billing guidelines are usually followed by private insurers as well.

Federal Laws, Compliance and Certification

When navigating the maze of radiation oncology billing guidelines, federal laws also come into play, including the Fair Debt Collection Act, HIPAA and the Privacy Rule.   For Medicare and Medicaid reimbursement, certification and compliance also play a role.  The Social Security Act mandates the establishment of minimum health and safety standards.  The Clinical Laboratory Improvement Amendments set standards that must be met by providers and suppliers participating in the Medicare and Medicaid programs.

With Periop, your practice’s billing responsibilities are the in the hand of Certified Coding Specialists who maintain the highest level of training and changes within the industry.  In an effort to stay current on all the latest  billing issues and compliance, our team attends all of the most prestigious professional conferences. Among some of the notable conferences we will attend this year include the American Society for Radiation Oncology event in Atlanta, GA as well as The Association of Community Cancer Centers event in Boston, MA.

Take Care of Your Patients.  We’ll See to the Billing.

Periop’s medical billing services for radiation oncology lift the burdens of RCM, giving you the resources to focus on your patients. We ensure that your practice complies with all insurance company, Medicare and Medicaid guidelines and applicable laws such as HIPAA. Our team of medical billing specialists, radiation oncology coders and patient care representatives complement our high-tech software, helping you simplify your practice while reducing expenses and saving you time. Because proper compliance is at the heart of what we do, we have the following capabilities:

  • Claims submission management: Using our cutting-edge radiation oncology billing system, Periop ensures all claims are verified and accurate before submission,
  • Reimbursement management: We’ll diminish your percentage of denied or underpaid claims by actively overseeing all accounts and work with carriers to ensure every claim meets compliance standards, so you receive reimbursement in full, and
  • Claims follow-up, denial resolution, appeals and collections: Being proactive is key to your financial success, and we don’t take that responsibility lightly.  Claims are sometimes denied, even when submitted correctly. Our reimbursement specialists will collaborate with carriers to investigate potential errors, so that claims are resolved in a timely manner for maximum payment.

Periop is an advanced solution that offers ease of compliance with the medical billing guidelines specific to radiation oncology practices.  Uniting our niche-area expertise with sophisticated technology, we provide a fully integrated solution that is tailored to your unique practice.  We focus on compliance and full reimbursement, allowing you to focus on treating your patients.