Facing these Oncology Medical Billing Challenges? Pulse Medix is Here to Help!
Complex Nature of Oncology Billing
Cancer treatment is a long and difficult process for everyone involved. Patients can go through rapid changes in their health and face a variety of symptoms, making billing quite complex. Even when the treatment plan is straightforward, you’ll still need to handle billing for:
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Consultation -
Preparation -
Treatment -
Follow-up
Each of these steps needs to be approved and covered by insurance, so having a team that truly understands the ins and outs of major healthcare plans is essential.
Changes in Regulations and Compliance
Oncology billing is always changing due to advances in cancer treatment and research. New technologies and better diagnostics mean compliance and coding standards are constantly updated.
This makes it hard for practices and billers to stay current and compliant. As new tech comes out, insurance companies, doctors, and staff all need to adapt. Pulse Medix has a well-versed team of medical billers and coders that will take care of everything to boost your practice revenue.
Turnover Training
Having a dedicated management team to oversee staff is essential. However, turnover and the hiring process can lead to revenue losses and delays in billing, especially when the team is short-staffed.
A unique challenge in oncology medical billing is its vulnerability to fraud without proper checks and balances. Pulse Medix takes patient privacy very seriously. Our oncology billing services are fully HIPAA compliant to safeguard your patients’ data.
Our Oncology Revenue Cycle Management Services Boost Revenue
Changes in Regulations and Compliance
Our team includes experts in insurance eligibility verification who will contact insurance companies to confirm coverage, benefit options, demographic information, and prior authorization requirements for each patient on their service date.
Payment Posting & Secondary Billing
We record electronic payments in the client’s billing software and manage exceptions manually to ensure each payment is accurately posted. The Electronic Remittance Advices (ERAs) are stored either in the billing software or a document management system (DMS) for future reference. After posting insurance payments, our billers verify if any secondary claims need to be created and submitted.
Pre-authorizations/Prior Authorizations
Insurance plans often require pre-authorization for certain services, and it’s up to the provider to handle these requests. Since patients usually don’t know about CPT codes or when pre-authorization is needed, it falls on the provider to manage this process. Pulse Medix makes it easier by taking care of the pre-authorization process for you, ensuring that everything is handled smoothly and efficiently.
Denial Management and Resolution
We have a skilled team of oncology billing and coding professionals who are experts in healthcare. Pulse Medix enhances this by actively managing denials and providing targeted strategies to resolve them efficiently.
Patient Demographic Entry
Getting patient information right is essential in medical billing and coding because it directly affects insurance claim payments. Our experts take great care in entering patient data accurately, knowing that even small mistakes can lead to claim denials.
A/R Follow Up
At Pulse Medix, we know how crucial it is for physicians to keep their practices running smoothly and successfully. That’s why our oncology billing services focus on thorough A/R follow-up. We understand all the ins and outs of claim denials and work hard to shorten the time it takes to follow up on pending claims.
Coding & Billing
We get that timely medical billing and coding are essential. By letting us handle these tasks, you can avoid the hassle of follow-up and administrative work related to billing and coding. This frees you up to focus on providing excellent healthcare to your patients.
Patient Statement Preparation
Our team is dedicated to making sure patient statements are accurate before final bills go out. Every month, we generate patient statement reports and carefully review all the details to ensure everything is correct before sending them out.
The Perks of Outsourcing Oncology Billing Services to Pulse Medix
Scalability
As your practice grows, so do your oncology medical billing needs. Pulse Medix offers scalable solutions that can adapt to the changing demands of your practice, ensuring consistent and reliable billing support.
Reduced Administrative Burden
Outsourcing your oncology billing to Pulse Medix reduces the administrative burden on your staff. We handle all aspects of the billing process, from claim submission to follow-up, allowing your team to concentrate on other important tasks.
Access to Advanced Technology
Pulse Medix uses cloud-based oncology billing software and technology to streamline the billing process. This ensures efficient claim submission, tracking, and follow-up, resulting in faster reimbursements and fewer administrative hassles for your practice.
Improved Revenue
We focus on minimizing claim denials and accelerating the reimbursement process, which leads to improved cash flow and financial stability for your practice.
Cost Savings
Managing an in-house billing department can be costly, with expenses related to staffing, training, and technology. By outsourcing to Pulse Medix, you can significantly reduce these costs. We don’t get paid until you do.
Ready to Accelerate Your Collections?
Pulse Medix is the leading oncology medical billing company in the USA. Get in touch with us now and join our growing list of satisfied customers.