Prevent claim denials in Oncology medical billing - PowerPoint PPT Presentation

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Prevent claim denials in Oncology medical billing


Things you should analyze in your Oncology medical billing, prevent Oncology Billing Denials, reduce AR days, understand MACRA changes. – PowerPoint PPT presentation

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Title: Prevent claim denials in Oncology medical billing

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Prevent claim denials in Oncology medical billing
Before we understand how different factors would
be affecting the Oncology medical billing we need
to understand different changes for the Last year
and how they have affected us. Medical billing is
seeing a new string of changes in regulating the
medical billing and coding of the procedures and
diagnostic.  In last year, different medical
challenges were faced by various specialties with
the foremost one being the shift of Medicare
towards quality-based programs. This included
an Ambulatory surgical center facing the flank
from the insurance company and patients. One of
the major changes we saw was an increase in
medical billing denials from private insurance
companies which let too long appeals from the
doctors. The number of AR days has increased from
an average of 20 days to 24.5 days- this includes
the payment from both the insurance company and
individuals.   MACRA Changes Medicare Access and
CHIP Reauthorization Act saw a unique mechanism
to be put for the quality check and improve the
medical care. This led to an incentive-based
payment system by forming an advanced alternative
payment model. The model was set to structure
different MIPS quality measures which will help
to provide better medical care towards the
patient population with efficiency and quality
Prevent claim denials in Oncology medical billing
MACRA was one of the first to put in rules which
laid the foundation of incentivized payment on
the quality of patient care and outcomes. Many
doctors have even guessed that this would start
when we would be seeing the phase-out of fee for
service. Entry of New Codes Medicare
implemented a 3 tier evaluation code and 1 new
reevaluation code this was laid out last year
with the CPT manual. All the new codes have been
evaluated and added to the list of always. This
also brings a lot of stress on different
evaluation and improvement techniques for the
coding of the bills. Post-Acute
Reform Post-Acute reform is important to improve
the Medicare Post-acute-acre transformation act
this continues to serve the purpose of moving
forward and implementing different quality
measures and data collection requirements. Oncolo
gy Medical Billing Facing an Uphill Task.
Prevent claim denials in Oncology medical billing
None of this is astounding. In numerous regards,
it is an outcome of the expanding costs and the
powerful money-related edges related to oncology
practice.   For instance, the rate of securing
private oncology hones by healing facility
frameworks is higher than for most different
subspecialties. In spite of the fact that this
may, to a limited extent, reflect expanded
rivalry for patients, the high incomes produced
by oncology rehearses are probably going to be
another driver of this pattern. Increasing
expenses are at the core of the expanding weight
of earlier approval, disavowals, and distributed
audits, which are presently a normal piece of
oncology rehearse. The effect of these issues for
oncologists and for patients is winding up more
obvious. How to Prevent Oncology Practice
Billing Denials? Patient Care and Billing
management have to be different things when it
comes to cancer care. The complexity of each
patient and the need for a billing company is
imperatively felt during such a stage.
Prevent claim denials in Oncology medical billing
  • Here are Five Things You Should Analyze in Your
    Oncology Billing
  • Payers
  • Competition
  • Staffing
  • Clinical Research
  • Electronic Health Records
  • Oncology medical billing is difficult and what
    makes it more difficult is regulation and coding.
    Payers and competition hold the first and second
    spots because they tend to have more effect on
    revenue generation. Payers form a wheel of your
    practice and complete the stones on the road.
    Staffing cost is one of the reasons why most
    oncologists today prefer to start with a hospital
    or group. Clinical Research and EHR are part of
    your billing and development process through a
    part of this can be outsourced to a medical
    billing company.
  • Ready to Outsource Oncology Medical Billing?
  • We at Medical Billers and Coders (MBC) simplify
    the billing process for Oncology with a
    streamlined revenue cycle management process. You
    can get in touch with us at 888-357-3226 or email
    us at
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