How Insurance Verification Causes Oncology Billing Delays

Oncology billing delays are quite common. Every part of the process is full of hurdles that increase waiting times. Right from getting authorization for complex procedures like Chemotherapy to submitting claims with multiple components – oncology billing is time-consuming.

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But is there any way to minimize these delays? The answer is yes. And to make that possible every stage in the billing process should be optimized for it.

Pre-billing steps like insurance and eligibility verification delay processes right from the start. Oncologists & providers are frustrated with long adjudication times and unnecessary denials even for medically necessary procedures.

Optimize Oncology Billing Operations by Streamlining Insurance Verification

These delays are inevitable. And oncology billing operations should take this into account. By performing insurance verification and other related processes proactively about 40% of the delays can be reduced. This way billing professionals can stay prepared with all related information and shorten authorization request time.

Here are a few ways proactive eligibility and coverage verification can reduce waiting times:

1) Information processing before doctor’s appointment

With proactive insurance verification practices, front-desk staff collect patients’ insurance details during appointment scheduling. This helps them verify insurance information and step up the rest of the processes based on factors like insurer, health plan, and network criteria.

2) Awareness of patient’s eligibility and coverage benefits after prescription

After checking the doctor’s prescription, oncology billing staff are able to identify authorization requirements, coverage benefits, co-payments, and deductibles for the patient. This reduces the time required to check the eligibility and coverage benefits of the patient.

3) Swift submission of authorization request

In billing operations at oncology practices, proactive insurance verification allows providers to submit PA requests in a short time period of time. They are able to submit requests shortly after the doctor’s appointment. All they need to do is collect all the required information and fill out authorization forms electronically using payers’ portals.

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Maximize Revenue with Oncology Billing Services

Non-clinical admin functions like pre & post-billing tasks, and AR management require expertise. And oncology billing services have the edge in these functions over providers because their area of focus is optimization of billing operations. With billing experts, oncologists can easily get rid of their administrative burdens and improve billing accuracy.

This way they are able to maximize the efficiency of the practice. Billing services work on a dedicated full-time resource model without any requirement for employee or medical benefits. These resources work from across required time zones to support providers’ requirements.

They are also certified and experienced in billing for oncology procedures and services. This helps providers including private physician practices to increase their billing accuracy and maximize revenue.

To learn more about how our oncology billing services have helped reduce insurance verification delays and costs for providers, please contact Sunknowledge Services Inc., a HIPAA-compliant healthcare revenue cycle management organization serving US healthcare providers & payers since 2007.