Oncology Medical BillingOncology Medical Billing

Oncology medical billing can be a complex and confusing process for both medical professionals and patients. Understanding the most common reasons for denials can help providers and billing teams to prevent and appeal denied claims. 

Your revenue cycle is a continuous Process. Many of the coding-related problems you find during the initial round of analysis and corrections may be solved at a high level. In order to avoid repeated faults, you must continually review and make structural corrections to your Oncology coding.

What Is Oncology Medical Billing?

Oncology medical billing is the process of submitting and receiving reimbursement for medical services related to the diagnosis and treatment of cancer. This includes billing for services such as diagnostic tests, surgical procedures, radiation therapy, and chemotherapy. Oncology medical billing requires a detailed understanding of coding and billing guidelines, as well as knowledge of the specific procedures and treatments used in cancer care. 

Due to the complexity and high cost of cancer treatment, oncology billing and Coding can be a challenging process that requires careful attention to detail and a thorough understanding of the reimbursement process. Additionally, effective communication between the medical team and the billing team is essential to avoid denied claims through accurate billing.

oncology medical billing
oncology medical billing

Top 8 Oncology Medical Billing Denials

Here are the top 8 denials in oncology billing:

  1. Missing or incomplete documentation. One of the most common reasons for Oncology denials is missing or incomplete documentation. This can include missing physician’s orders, missing treatment plans, or missing signatures. To prevent these types of denials, it’s important to have a thorough and accurate documentation system in place and to make sure all necessary documentation is obtained before submitting claims.
  2. Inaccurate Oncology coding. Another common reason for denials is inaccurate coding. This can include using the wrong codes, using outdated codes, or using codes that are not medically necessary. To prevent these types of denials, it’s important to have a thorough understanding of coding guidelines and to stay up-to-date on any changes to codes or billing regulations.
  3. Lack of medical necessity. Medical Necessity is another top leading cause of denial, if not checked before submitting a claim to insurance. In order to avoid these types of denials, it is essential to become familiar with what services a patient’s insurance plan covers and whether any services are medically necessary.
  4. Pre-existing conditions. A patient may have their claim denied if their insurance plan does not cover their preexisting condition. To prevent these types of Oncology Medical Billing denials, it’s important to be aware of any pre-existing conditions a patient may have.
  5. Duplicate billing. Claims could lead to denials if insurance found any kind of over or duplicate coding in the claims. This can happen if the same service has been billed multiple times, or if the same service is billed under different codes. To prevent these types of denials, it’s important to have a system in place to detect and prevent duplicate billing.
  6. Timely filing. Claims can be denied if they are not filed within the timeframe specified by the insurance plan. To prevent these types of denials, it’s important to be aware of the filing deadlines for each insurance plan and to submit claims as soon as possible.
  7. Provider, not in-network. Insurance providers can reject claims if the patient’s plan does not include the provider in its network. It’s imperative to verify the patient’s insurance coverage and to ensure the provider is in-network before receiving services in order to prevent these kinds of denials.
  8. Authorization not obtained. Lack of prior authorization from insurance while providing treatment is a leading cause of claim denial. Obtaining pre-authorization before providing any services that might require it is critical to preventing these types of denials.

Understanding the most common reasons for denials in oncology medical billing can help providers and billing teams to prevent and appeal denied claims. By staying up-to-date on coding guidelines, obtaining necessary documentation, and verifying insurance coverage, providers can help ensure that claims are processed smoothly and that patients can get the care they need.

How does NEO MD Works?

The No Surprises Act and state legislation have rapidly transformed the Medical Billing industry. Partnering with third-party Revenue Cycle Management companies is now more beneficial than ever.

NEO MD offers superior Oncology Medical Billing and coding services across all 50 states in the US. We tailor our billing services to meet the specific needs of physicians while complying with mandatory coding regulations. Additionally, our Revenue Cycle Management services are regularly updated with the latest CMS guidelines.

Furthermore, NEO MD Medical Billing provides the highest quality and value in Medical Billing Services to ensure efficient cash flow. Our services are affordable and transparent, with no hidden charges.”

What Makes NEO MD the Best Medical Billing Services Company?

NEO MD stood best among competitors due to ensuring the latest CMS Medical Billing and coding guidelines; 

  • Our experts work hard to reduce your front-end denials by 20%
  • First level of Claim acceptance rate 95-98%
  • Improve RCM system efficiency with a robust credentialing team 
  • Offer internal Medical Billing audits to uncover loopholes
  • Offer Provider & Staff Productivity Analysis
  • Provide fortnightly financial and practice overviews 
  • Refunds adjustment and Payment posting to improve the cash flow
  • Identify potential under, over, and incorrect coding scenarios
  • Deliver customized Revenue Cycle Management Services to unearth operation shortcomings
  • Out of Network Negotiations
  • Evolving state-of-the-art medical billing services for small practices
  • We have consistently increased the collection rate for our clients because of the faster increase in the accuracy of fees and collection
  • Provide Medical Billing and collection services that are of high quality and error-free

Let’s Schedule a Demo to learn more about how we can improve your medical practice management. Get us at! (info@neomdinc.com) or (929) 502-3636).

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