Maximize Reimbursements for Chemo, Infusions & Immunotherapy
Oncology Billing Services
Partner with RxCredentialing for oncology medical billing services that reduce denials, speed up payments, and let your oncology practice focus on patient care.
- 96400-96549 Infusion Coding Experts
- Oncology-Specific AR Recovery
- QPP/MIPS Compliance
- Oncology-specific CPT & ICD-10 expertise
- Faster claims processing & A/R follow-up
- Compliance with Medicare, Medicaid & private payers
Free Credentialing with Medical Billing
$499 / Month
Call / WhatsApp:
(716) 919-3969
Email:
support@rxcredentialing.com
www.rxcredentialing.com
Orthopedic Medical Billing Services
Medical Billing Services
- ✅ Smooth transition between EHR/EMR systems.
- ✅ Efficient Electronic Funds Transfer (EFT), EDI, and ERA setups.
- ✅ Claims submission within 24 hours.
- ✅ Prompt follow-up with payers for faster reimbursements.
- ✅ Free CAQH maintenance and provider revalidation.
- ✅ Comprehensive Revenue Cycle Management (RCM) services.
- ✅ Appeals, adjustments, and coding review included.
- ✅ Referral coordination with other practices and specialists.
- ✅ Reimbursement strategies for optimized billing.
Simplify Oncology Billing. Maximize Reimbursements.
Biggest Challenges
Complex Infusion Coding (96400-96549)
42% of oncology practices undercode infusion services due to complicated start/stop times and concurrent drug administration rules, leaving $85k+ annually unbilled.
Our Expertise:
Oncology-certified coders achieve 98% accuracy in infusion coding
Clinical Trial Billing Compliance
Medicare's NCD 310.1 rules result in 35% claim denials when routine vs. trial costs are improperly documented.
Our Expertise:
Trial-specific charge capture workflows reduce denials to <5%
Prior Authorization Delays
58% of oncology practices report 7-14 day delays for chemo/immunotherapy approvals, disrupting treatment schedules.
Our Expertise:
24-hour emergency auth service cuts delays by 72%
Drug Wastage Documentation
J-codes for unused portions (J9041, J9201) are missed in 63% of cases, costing $12k+/month per practice.
Our Expertise:
Wastage tracking system recovers 92% of eligible amounts
MIPS/QPP Penalties
74% of oncologists face 9% Medicare cuts due to incomplete quality reporting for chemotherapy regimens.
Our Expertise:
Auto-populated QPP dashboards ensure 100% compliance
Patient Responsibility Collections
High-cost treatments result in 47% patient AR >90 days, averaging $142k annual losses per oncologist.
Our Expertise:
Custom payment plans increase collections by 65%
Schedule a Consultation with Our Medical Billing Experts
We understand your need to keep things small, intimate, and personalized. Our medical billing specialists for independent small practices thoroughly study your needs and offer custom-made solutions.
Oncology Billing Services
We Offer
Oncology Medical Billing Services
Process
Benefits of Outsourcing
Oncology Billing Services
Infusion Coding Expertise
Specialized coders maximize reimbursements for 96400-96549 series, hydration, and chemotherapy administration codes.
98% Clean Claim RateClinical Trial Billing
Proper segregation of routine vs. trial costs per Medicare NCD 310.1 and commercial payer policies.
100% Compliance AuditsPrior Authorization
Expedited approvals for chemotherapy, immunotherapy, and radiation therapy treatments.
72% Faster ApprovalsDrug Wastage Recovery
Accurate documentation and billing of unused drug portions (J-codes) per FDA guidelines.
$18k+/Month RecoveredQPP/MIPS Optimization
Maximize incentive payments while meeting Oncology Care Model (OCM) requirements.
9% Medicare BonusPatient Collections
Custom payment plans and financial counseling for high-cost treatment responsibilities.
65% Collection RateOncology Medical Billing Services
FAQs
How do you handle chemotherapy infusion coding (96400-96549)?
Our oncology-certified coders document:
- Exact start/stop times for initial (96365) and sequential (96366) infusions
- Concurrent drug administration per CPT hierarchy rules
- Hydration therapy (96360-61) when medically necessary
What's your denial rate for oncology claims?
We maintain a 4.7% denial rate (vs. 22% industry average) through:
- Pre-submission clinical validation
- Real-time NCCI edits checking
- Oncology-specific claim scrubbing
Do you support clinical trial billing (NCD 310.1)?
Yes. We implement:
- Dual charge capture (routine vs. trial costs)
- Medicare Coverage Analysis (MCA) integration
- Sponsor-specific billing grids
Example: Proper J9999 billing for non-covered investigational drugs
Phase I-IV Trial ExperienceHow do you capture drug wastage (J-codes)?
Our process includes:
- NDC-matched documentation of unused portions
- FDA single-use vial policy compliance
- Wastage calculation templates (1mg = $X)
Commonly missed: J9041 (rituximab), J9201 (irinotecan)
$22k+/Month Average RecoveryWhat's your turnaround time for prior authorizations?
Standard services:
- 48 hours for non-urgent chemo/immunotherapy
- 24 hours emergency expedited review (+$25 fee)
We specialize in high-denial drugs like J9271 (pembrolizumab) and J9355 (trastuzumab)
92% First-Pass Approval RateHow do you optimize MIPS/QPP for oncologists?
Our oncology-specific approach:
- Auto-populated quality measures (e.g., #404: Risk Assessment)
- Chemotherapy regimen-specific reporting
- OCM (Oncology Care Model) compliance tracking
Do you work with my EHR (Epic, Cerner, etc.)?
We integrate with all major oncology EHRs:
- Epic Beacon - Treatment plan synchronization
- Mosaiq - Radiation therapy charge capture
- Flatiron - Real-world data alignment
How do you handle high patient responsibility balances?
Our financial advocacy program:
- Pre-treatment cost estimates
- Pharmacy benefit investigation
- 12-month 0% interest payment plans
What about radiation oncology coding (77261-77427)?
Our RO specialists handle:
- Treatment planning (77261-77263)
- IMRT (77418) vs. 3D-CRT (77412) differentiation
- Brachytherapy documentation (77750-77799)
How quickly can you start billing for our practice?
Typical onboarding timeline:
- Day 1-3: EHR integration & credentialing
- Day 4-7: Charge capture workflow testing
- Day 8-10: Go-live with parallel billing
Oncology Billing Services
Insurances Covered
Medicare
Medicaid
VA Health
TRICARE
ACA Marketplace
UnitedHealthcare
Aetna
Cigna
Humana
Anthem
BCBS National
BCBS Alabama
Florida Blue
BCBS Michigan
Empire BCBS
Horizon BCBS
BCBS NC
Highmark BCBS
BCBS Texas
Premera BCBS
Kaiser Permanente
Molina
Centene
Oscar Health
Health Net
CDPHP
Capital Blue
Independence BC
CareFirst
Regence BCBS
UHC Medicare
Humana Medicare
Aetna Medicare
Cigna Medicare
BCBS Medicare
Trusted Medical Billing Services
Verified Results
Rx Credentialing LLC did an excellent job helping my practice join the MCOs. Their team made the process seamless and stress-free, answering all my questions promptly. I highly recommend them—their service is efficient, professional, and reasonably priced! 😁
I am a licensed psychotherapist and could not be more pleased with the efficient, professional services from RX credentialing services. No AI or bots here. Instead, RX offers real human beings who understand the needs of solo providers or group practice owners who are spread thin and have to wear many hats. Rx has hired talented individuals, like my account manager, Tyler, who will go the extra mile for you to ensure credentialing goes smoothly. We hit a hiccup on the road to becoming credentialed, but Tyler quickly intervened, advocating for my business so that the issue was resolved and I was approved for various insurance panels--some which have very high bars or administrative requirements. RX handled it all, informing me through each step of the process with clear and concise credentialing updates that put my fears to rest. Their services are kind of like therapy for therapists, because when you worry less about admin burdens, you can better focus on the client, while growing your business capacity. I would highly recommend them to any solo or group practice needing such services.
RxCredentialing has been a wonderful partner in helping with my credentialing for my new primary care practice as well as are assisting me with a few other services. They are very knowledgeable and most importantly they are not pushy in working with my needed timeline. Moreover, they are very responsive, and I am looking forward to expanding our relationship to include their other services such as medical billing. I was fortunate to find them while searching the web and so refreshing to deal with an organization that is really focused on helping me establish a medical practice the smart way and not just spend money foolishly on things I do not need until the time is right.
Adam and his team are excellent at what they do. They walk you through every step of the process. Highly recomend Adam and his team. always responding in quickly.
Attention to detail
Very attentive and efficient
Always available to explain things or answer questions or concerns
Very attentive and efficient
Always available to explain things or answer questions or concerns
Tyler has been an excellent person to work with. He kept us (our clinic) informed of our status throughout the credentialling process. They did the "heavy lifting" tracking down and following up so we didn't need to. Because this company handled our credentialling process, it allowed our company to focus on our number one priority--patient care. Thanks for taking care of us!!
they handled the issue quickly and professionally. I truly felt supported and confident in their assistance.
I can’t say enough great things about RX Credentialing! From the beginning, they’ve been incredibly efficient, responsive, and always a pleasure to work with. Anytime I had a question or needed assistance, they got back to me quickly with clear, helpful answers. They made the entire credentialing process smooth and stress-free! It truly feels like they care about their clients and go the extra mile to make sure everything is handled correctly and on time. I would highly recommend RX Credentialing to anyone looking for a credentialing partner who delivers every time!
David is wonderful very responsive and on top his work. Great experience.
Making the decision to use Rx Credentialing for my billing service was a game changer for my practice. Solo practice as an NP and lipid specialist has been challenging for sure. Rx Credentialing has provided the professional knowledgeable support I needed. I am so grateful to be partnering with them for my billing and credentialing needs.
The staff is great and very helpful. I have been with them for 2 years with no complaints. I am very satisfied with their service.
I have been working with this company for over a year and I have no complaints…They are really the best at what they do.
Trusting a third party with your sensitive information can be difficult. I encountered this challenge while seeking credentialing services for my business with various insurance providers. Although I received numerous proposals from credentialing firms, I was uncertain about the security of my personal data. A trusted colleague recommended Rx Credentialing LLC, based on her positive experience. I decided to engage their services, and I’m pleased to report that they handled my information securely. Moreover, their expertise and competitive pricing make them an excellent choice for anyone needing credentialing support.
Adam is very professional and kind, always responsive when I need assistance. I have billing service through this company which has been going good so far. I was lucky enough to get a wonderful virtual assistant from Adam, I don’t know what I would do without her.
Rx Credentialing did a phenomenal job assisting with credentialing for my Ophthalmology practice start-up. Tyler is responsive and kept me up to date throughout the entire process. I would recommend Rx Credentialing to anyone hands down the best. Dr. Montenegro.
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