Oncology Billing and Reimbursement Experts

What we do

Comprehensive Billing Services

From initial payor setup through ongoing compliance management, we handle every stage of your revenue cycle.

• Payor Credentialing & Contracting

  We manage the full credentialing lifecycle — initial enrollment, re-credentialing, and contract negotiations with Medicare, Medicaid, and commercial payors. Proper credentialing is the foundation of clean claims and timely reimbursement.

  • Medicare and Medicaid enrollment
  • Commercial payor credentialing (BCBS, Aetna, UHC, Cigna, and more)
  • Group and individual provider enrollment
  • Contract review and fee schedule negotiation
  • Re-credentialing and expiration tracking

• Review of Existing Billing Practice & Improvement

  We audit your current billing workflows, coding patterns, and denial trends to identify revenue leakage and compliance gaps. Our findings come with a concrete improvement roadmap — not just a report.

  • Coding accuracy and CPT/ICD-10 review
  • Denial pattern analysis and root-cause identification
  • Charge capture workflow assessment
  • Fee schedule benchmarking against Medicare rates
  • Written improvement plan with prioritized action items

• Routine Billing — Radiation Oncology & Medical Oncology

  Day-to-day claim submission, follow-up, and payment posting for radiation therapy and medical oncology services. We handle the full claim lifecycle so nothing falls through the cracks.

  • Radiation therapy technical and professional component billing
  • Chemotherapy and immunotherapy administration coding
  • Evaluation and management (E/M) service billing
  • Electronic claim submission and clearinghouse management
  • Payment posting, reconciliation, and patient balance management

• Periodic Auditing

  Scheduled internal audits keep your billing program compliant and your reimbursement optimized. We review documentation, coding, and billing patterns on a regular cadence to catch issues before payors do.

  • Quarterly or semi-annual coding audits
  • Documentation adequacy review
  • Overpayment identification and voluntary refund management
  • Audit trail documentation for compliance records
  • Benchmarking against specialty-specific coding norms

• Response to Billing Queries

  When payors, patients, or regulators raise questions about claims, we respond promptly and accurately. Our team handles appeals, reconsiderations, and payer correspondence so your staff isn't pulled away from clinical operations.

  • Claim denial appeals and reconsiderations
  • Payor audit response and documentation support
  • Patient billing inquiries and dispute resolution
  • Prior authorization and pre-certification management
  • Coordination of benefits (COB) issue resolution

• Compliance & Regulatory Management

  Oncology billing operates under intense regulatory scrutiny. We keep your practice aligned with CMS guidelines, OIG compliance program recommendations, and state-specific requirements — protecting you from audits, penalties, and recoupments.

  • HIPAA privacy and security compliance oversight
  • OIG compliance program implementation support
  • CMS billing guideline updates and staff education
  • Stark Law and Anti-Kickback Statute awareness training
  • Annual compliance risk assessment