Oncology Billing That Fights for Every Dollar
Between complex infusion coding, J-code fluctuations, and ever-changing payer policies for novel therapies, oncology billing requires specialized expertise. We help cancer centers and oncology practices navigate these challenges—so you can focus on what matters most: patient care.
Last quarter alone, we recovered $327,000 in previously denied claims for a 12-physician oncology group by correcting infusion time documentation and JW modifier usage. But beyond the numbers, we give you back the time and peace of mind to concentrate on your patients.
Get Your Free Revenue AnalysisPrecision Infusion & Chemotherapy Coding
We handle the complexities that often lead to underbilling or denials in oncology practices:
Time-Based Services
- Proper documentation of start/stop times
- Sequential vs concurrent infusion coding
- Hydration therapy documentation
Drug-Specific Challenges
- JW/JZ modifier application for wastage
- Biosimilar vs reference product coding
- Documentation for high-cost drugs
Case Study: For a practice administering pembrolizumab, we implemented:
✓ JW modifier tracking for partial vials ✓ Proper documentation of infusion times ✓ Prior auth verification for each cycle ✓ Quarterly J-code updates
Result: 22% increase in drug reimbursement within 3 months
Prior Authorization & Clinical Trial Support
We navigate the complex prior authorization landscape for oncology practices, including:
Standard Therapies
- Chemotherapy regimens
- Radiation therapy planning
Novel Treatments
- CAR-T cell therapies
- Immunotherapy combinations
Research Protocols
- IND number documentation
- Medicare qualifying trials
Did You Know? We maintain a database of 150+ payer-specific policies for oncology drugs, updated weekly to reflect new coverage determinations.
Comprehensive Drug Revenue Management
Our systems ensure complete capture of every billable component in oncology drug administration:
J-Code Accuracy
Quarterly updates to reflect pricing changes
Wastage Tracking
JW/JZ modifier compliance
Buy-and-Bill
Inventory reconciliation
Our Drug Revenue Process:
- Verify J-code assignments match current ASP files
- Document single-dose vs multi-dose vial usage
- Track discarded amounts for proper JW reporting
- Reconcile inventory with billing records
Specialized Oncology Denial Resolution
We fight back against the most common—and costly—oncology claim denials:
Medical Necessity
- NCCN guideline documentation
- Prior auth discrepancies
Coding Issues
- Incorrect J-code assignments
- Missing modifiers
Clinical Trials
- Routine cost denials
- IND number requirements
Our Appeal Success Rate:
✓ 89% overturn rate for medical necessity denials ✓ $428,000 recovered last quarter for one practice ✓ Average 22-day resolution timeline
"When we switched to their oncology billing team, they identified that we were missing nearly $18,000 monthly in unreported drug wastage. Their JW modifier tracking system alone increased our collections by 27% in the first quarter. More importantly, they handle all our prior auths for novel therapies—I no longer have to delay treatment while waiting for approvals."
Dr. Elena Rodriguez
Oncology Partners of Texas
Ready to Optimize Your Oncology Revenue?
Get a free analysis of your last 90 days of chemotherapy and infusion claims. We'll identify your top opportunities to:
- Reduce drug-related denials
- Improve J-code accuracy
- Streamline prior auths