Allergy & Immunology
Did you know that Medicare pays for chemotherapy administration only if the oncologist gives the patient a cancer diagnosis?
Oncology practices face reimbursement reductions, frequent coding changes, evolving compliance rules and payor ignorance regarding the latest technology. Unprofitable chemo & non-chemo drug reimbursement, negative payment margin on drug purchases and complex coding and billing requirements seriously erode practice revenue. Coding and medical billing errors such as the misuse of modifiers to identify services, treatment or improper documentation frequently lead to denied and misadjudicated claims.
Oncology billing is complex and requires a high level of experience and knowledge for appropriate coding, modifier application and payor-specific medical billing procedures. Medical billing specifics regarding multiple chemotherapy administrations, therapeutic infusion and injection reporting, code bundling, etc., require ever increasing levels of expertise and efficiency.
PGM has more than three decades experience in oncology billing. PGM will work hand in hand with your practice to help identify problem areas such as correct modifier application, and educate your practice on best-in-class billing practices and procedures. Our team of certified medical coders and billing experts will manage all aspects of your oncology billing to help ensure your practice receives proper compensation for services provided.
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