Oncology Medical Billing Services
As the Affordable Care Act (ACA) was implemented many oncologists feared that in years to come many oncologists will have to embrace the administrative work and it will become more about coding rather than patient care. Oncologists had to deal with changing regulatory requirements of insurance companies and modifiers that take almost 30 percent of every physician’s time.
Legion Healthcare Solutions (LHS) over the past several years worked with many oncologists who deal with stressful patient conditions and rapid technological change. To make this transition of oncology physicians, we deploy billing managers for each oncology practice, who understand the practices moto of patient care. Dealing with evaluation and management codes is a challenge for any physician and Legion understands this, we deploy our certified coders for each claim.
“Each oncology practice we have worked with over the years have been different, some cover very specific part or refer the patient to some other expert. In oncology practice, patient care is most important hence usually we get 24/7 calls about urgent patient inquiries that we need to verify from an insurance company. Being an oncologist is not an easy job sometimes they need to give the terminal stage news to family members which is draining. Understanding this Legion deploys a 24/7 billing manager who takes all the back-end office task under their cover.”
– Oncology Billing Manager at Legion Healthcare Solutions (LHS)
Pre-authorization
Oncology physicians work with staff, technology, and several admin requirements. Prior authorization is the most important potential factor that results in an improvement in your revenue. Legion deploys resources to understand patients' underlying conditions to check for all potential costs- diagnosis and treatment. To reduce the operational burden, we approach the insurance companies with patients' information keeping in mind privacy.
Documentation
We kept documentation as our second point because most oncology practices usually don’t charge a patient if referred to other experts. Documentation starts after prior authorization has been received and the oncologist knows the part-details about the patient's condition. Payers usually demand documentation in oncology claims to understand patients' conditions, they may even demand an audit of patients' document and condition from other experts.
Coding
It’s very interesting what Legion experienced the other day, an oncologist from Boston had suggested to under code for certain diagnoses being conducted on the patient. Most oncologists fear that lack of coding knowledge will affect them in case of coding audits, however at Legion we are accurate and code to the level that you deserve.