Fixing Common Billing Errors in Oncology Medical Billing Services

1. Fixing Common Billing Errors in Oncology Medical Billing Services Introduction Oncology is a field of medicine that deals with the treatment and prevention of cancer in patients. The medical provider who practices oncology is generally known as an oncologist. Oncology is vast field sharing its territory with three major areas namely- medical, surgery and radiation. Now, these major are themselves classified into several subspecialties. Some of them are Neuro, Ocular, Thoracic, Gastro-intestinal, Bone and Musculoskeletal, Dermatological, Genitourinary, Gynecologic, Pediatric, Hemato, Geriatric, Pain and Palliative, Molecular, Onco-pathology, etc. Now, billing for each of these specialties is different. Each specialty has different coding rules and requirements. In the process of handling the billing chores simultaneously with other responsibilities, errors are pertinent. To prevent these errors, oncologists often outsource oncology medical billing to offshore service providers without verifying the required credentials. Here, we discuss some of the most common billing mistakes and how they can be avoided. Most Common Billing Mistakes Here are some of the most common mistakes when you outsource oncology medical billing to in-experienced medical billers: Incorrect or Missing Basic Demographic Information This is the most common mistake often committed by medical practice owners. Mentioning incorrect information related to basic details like name, address, payer enrollment number, eligibility information, etc. Submitting Duplicate Claims This includes sending the same claim time and again to the same payer when it is already processed by the insurance.

2. Claim Submission to the Wrong Payer This is the most fatal error that directly violates HIPAA law standards. Sending the sensitive health information to unauthorized person will render penalty or a term in prison. This occurs when a provider sends the claim to the wrong addressee. Incorrect CPT Code, Modifier or Diagnosis Mentioning incorrect codes related to services, codes, modifiers or diagnosis can result in claim rejections from the clearing-houses itself. Incorrect Sequence of Diagnosis Codes Most claims may include more than one or in some cases more than two diagnosis code for services provided. In these cases, it is important that they are arranged in a sequential manner. Determining which code is primary and which is secondary is important to prevent claim denials. Billing Services that are Not Covered under the Payer Agreement This error can occur when a medical provider bills for the services that are not covered in the payer fee schedule. Or, services are billed by some out-patient facility that is not in- network with them. Submitting claims after the TFL (Timely Filing Limit) This can be considered as the silliest mistake one could ever make. Submitting claims beyond the TFL results in loss of money and an exhaustive process of reconsiderations and appeals that may further delay the reimbursements. What can be done? With numerous responsibilities, it becomes difficult for oncologists to take care of everything at the same time. They are also left with a better option to outsource

3. oncology medical billing services. Here are some of the benefits of outsourcing that you can consider. Reduced Costs and Increased Savings When you outsource oncology medical billing, the costs of hiring and training new staff and managing their payroll get eliminated automatically. Adding to your savings is zero investment in infrastructure like computer systems, billing software, and its license, employee facilities, etc. Increased Knowledge Base Providers who outsource oncology medical billing services have access to some of the industry’s best billing experts who have years of experience and are trained regularly for keeping up with the latest advancements in the medical billing guidelines, rules and regulations. Compliance to HIPAA laws HIPPA stands for Health Information Portability and Accountability Act which was established in 1996 by the federal government and sets regulations to safeguard the health information of a patient. It has also set some standards and conditions governing its disclosure among others. An outsourced oncology medical billing company leaves no stone unturned to secure and maintain the privacy of sensitive patient health information. They are well aware of the consequences arising out of any case of the breach of confidentiality. Clearly, no business would want to serve their term in prison and pay a hefty amount of compensation out to the patient or the federal authorities. Improved Business Performance When you shift your billing work to an off-shore billing company, you take the workload off the shoulders of your in-house billing staff. And, with the reduced workload that in- house staff can work more freely leading to increased productivity and improved business performance at the same time.

4. Timely Reimbursements The industry experts at the oncology medical billing provider companies are well versed with the complex payer billing guidelines and the numerous coding rules and regulations. With the careful charges and demographics entry practices that they practice and the error-free submission of health claims, the reimbursements process becomes quicker and streamlined. If you are looking to outsource oncology medical billing services, Bikham Healthcare can be a perfect partner for you. Our certified oncology medical billing team has years of experience working with oncologists and is equipped with the necessary knowledge of the different oncology procedures to ensure that you receive reimbursements quickly and completely. Our range of services include: • Account Receivables Management • 12-hours claims processing • Electronic eligibility verification • Quarterly coding updates • System-based claims scrubbing • Handling billing calls

5. • Regular quality assurance checks • Regular reporting Visit www.bikham.com for more information.