How to Bill for Oncology Services

Oncology services usually involve expensive drugs, such as epoetin alpha, chemotherapy, nonchemotherapy infusions, hydration, injectables and radiation therapy. Therefore, billing timely and correctly the first time is very important. Expensive mistakes are costly and avoidable. One example of an expensive mistake would be if a patient was billed for 4,000 units of epoetin instead of 40,000. Administration fees should be billed for each administration of chemotherapy, infusion, injectables, hydration and nonchemotherapy. Finally, it is imperative, for example, if 6 hours of chemotherapy has been administered, proper documentation showing initial, subsequent, concurrent and additional treatment is maintained.

Things You'll Need

• Patient demographics
• Insurance information
• Coordination of benefit information
• Transcript of services provided
• Proper billing forms
• Computer

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Instructions

Oncology Billing

• 1

  Obtain patient demographics to include, correct birth date, insurances, member information for each insurance, insurance billing addresses and/or clearinghouse information.

• 2

  Verification must be done for each insurance company detailing co-pays, deductibles, yearly maximums and amount applied to date, calendar year or fiscal year, lifetime maximums with the amount applied to date, if more than one insurance be sure to get proper coordination information.

• 3

  Review patient insurance information to be sure co-pays and deductibles, where applicable, have been collected from the patient.

• 4

  Obtain transcript or patient file detailing services provided. Check that proper and accurate documentation has been provided for initial, subsequent, concurrent and/or additional administration of chemotherapy, nonchemotherapy infusion, hydration, injectables and radiation therapy.

• 5

  Enter billing information into computer or make copies and submit to off-site billing administrator.

• 6

  Create a system that will work for you to ensure that a followup is done on accounts that are not paid on time, are pending for additional information or need to be appealed due to all or part of the claim being denied.