Oncology Billing Services in the USA – AccuBill Solutions LLC
Introduction – Supporting Cancer Care with Smarter Billing
Oncology is one of the most complex medical specialties. Each treatment plan involves multiple chemotherapy sessions, infusion codes, and strict payer rules. Even a small coding or documentation error can cause claim delays or revenue loss. That is why AccuBill Solutions LLC provides specialized Oncology Billing Services designed for cancer centers, infusion clinics, and oncologists across the United States, including Miami and St Petersburg, Florida.
We combine medical expertise, compliant CPT and ICD-10 coding, and automated RCM systems to ensure accuracy, compliance, and steady cash flow.
What Are Oncology Billing Services
Oncology billing extends throughout the comprehensive financial workflow for cancer-care providers, from patient registration and prior authorization to claim submission and payment posting.
Our team takes care of every aspect of the revenue cycle, leaving you free to concentrate on your patients and outcomes
Core Components
- Coding and Charge Capture – Recording infusion, injection, and visit codes correctly.
- Claim Creation and Submission – Electronic filing through payer-approved systems.
- Payment Posting – Accurate tracking of remittance and adjustments.
- Denial Management – Reviewing payer responses and resubmitting corrected claims.
- RCM Reporting – Detailed financial reports that help you see revenue performance clearly.
Our Oncology Medical Billing Process
- Patient Registration and Insurance Verification
Confirm patient demographics, coverage, and prior authorizations before scheduling treatments. - Medical Coding and Charge Entry
Apply correct CPT and ICD-10 codes for chemotherapy, radiation, and follow-up visits. - Claim Scrubbing and Submission
Every claim is checked for NCCI edits and billing modifiers before submission to avoid rejections. - Payment Posting and Reconciliation
Payments are posted promptly using electronic remittance files for transparency. - Denial Analysis and Appeals
Our specialists review denial patterns, correct errors, and resubmit clean claims quickly. - Monthly Reporting and Review
Detailed financial summaries highlight collection rates, payer delays, and revenue trends.
This structured process keeps your oncology practice financially healthy and compliant.
CPT Coding in Oncology Billing
Precise CPT coding is essential for oncology claims because every chemotherapy or infusion service is billed separately.
Common Oncology CPT Codes
| CPT Code | Description | Purpose |
|---|---|---|
| 96413 | Chemotherapy infusion first hour | Primary infusion service per session |
| 96415 | Each additional hour of infusion | Add-on for longer treatments |
Each infusion must be documented with accurate start and stop times and matched to the proper diagnosis code.
ICD-10 Codes for Cancer and Documentation Accuracy
Oncology billing depends heavily on precise ICD-10 coding. Codes must describe the cancer type, site, and current treatment stage.
Examples of Common Oncology ICD-10 Codes
- C50.919 – Malignant neoplasm of unspecified site of female breast
- C18.9 – Malignant neoplasm of colon unspecified
- C34.90 – Lung cancer unspecified
- C61 – Prostate cancer
- C91.10 – Chronic lymphoid leukemia not in remission
Our certified coders ensure each claim has the correct ICD-10 pairing to support medical necessity.
Oncology Revenue Cycle Management (RCM)
Efficient RCM keeps your practice financially stable. Our Oncology Revenue Cycle Management services track every dollar from the moment a patient is scheduled until payment is received.
Key Benefits
- Reduced denials and payment delays
- Transparent cash-flow tracking
- Improved collections through automated follow-ups
- Compliance with Medicare and private payer guidelines
Our goal is to help oncology practices maintain profitability while delivering compassionate care.
RCM Automation for Oncology Practices
Automation streamlines repetitive tasks such as eligibility checks and claim scrubbing.
How RCM Automation Helps
- Real-time eligibility verification
- Automated charge capture from EHR systems
- Electronic payment posting and ERA reconciliation
- Predictive denial alerts based on payer trends
AccuBill Solutions LLC uses secure, HIPAA-compliant automation tools that save time and reduce human error.
Billing Modifiers and NCCI Edits
Understanding modifiers and NCCI (National Correct Coding Initiative) edits is critical in oncology billing.
Examples of Common Modifiers
- Modifier 59 – Distinct procedural service
- Modifier 25 – Significant E and M service on same day as procedure
- Modifier JW – Drug amount discarded not administered
Our software automatically checks NCCI edits to ensure that procedures billed together do not conflict, preventing rejections.
Insurance Verification and Compliance
Cancer treatments are expensive and usually require prior authorizations.
Our Verification Process
- Confirm coverage for chemotherapy and infusion services
- Verify plan limits and network requirements
- Document authorization numbers and payer guidelines
- Communicate coverage details to patients before treatment
This approach minimizes financial surprises for both providers and patients.
EHR Integration and Data Accuracy
We integrate directly with electronic health records to ensure that clinical data and billing data match perfectly.
Advantages
- Automatic charge import from EHR
- Reduced manual entry errors
- Real-time tracking of infusion sessions
- Faster claim submission and payment posting
Our systems connect smoothly with major platforms such as Epic, Athenahealth, AdvancedMD, and Kareo.
Why Choose AccuBill Solutions LLC for Oncology Billing
- Specialized team trained in oncology coding and payer policies
- Nationwide service coverage with a focus on Miami and St Petersburg, Florida
- HIPAA-compliant security for all data transactions
- 98 percent clean claim rate on first submission
- Regular compliance audits and training
- Transparent monthly reports with clear insights
We work as an extension of your team — not just another billing vendor.
Frequently Asked Questions (FAQs)
Q1. What are Oncology Billing Services?
They include coding, claim submission, and payment follow-up for oncology practices, ensuring each treatment is billed and reimbursed correctly.
Q2. Why is Oncology Billing so complex?
Because it involves chemotherapy infusions, drug codes, and multiple payer rules that change often. Specialized knowledge prevents costly errors.
Q3. What is CPT 96413 used for?
It is for the first hour of chemotherapy infusion and must be supported with accurate documentation of start and end times.
Q4. What does Oncology Revenue Cycle Management mean?
It refers to the complete financial process of handling claims from registration to reimbursement for cancer care services.
Q5. How do billing modifiers and NCCI edits affect reimbursements?
They dictate when services can be billed together. Modifiers, as in so many other arenas of medical billing, can spell denial or cut payment.
Q6. Can automation improve oncology billing?
Yes, automation decreases manual mistakes and speeds claim processing, shutting the loop on cash tracking as well.
Q7. Does AccuBill Solutions LLC serve oncology clinics nationwide?
Yes, we have clients all over the United States with a strong emphasis in Florida healthcare markets.
Q8. Are your oncology billing services HIPAA compliant?
Absolutely. Everything that AccuBill Solutions LLC does and all technologies we employ adhere to HIPAA / CMS acceptable guidelines for securing patient data.
Conclusion – Build a Healthier Financial Future for Your Oncology Practice
Oncology billing involves a deep knowledge of codes, payer rules and documentation requirements. AccuBill Solutions LLC brings that expertise to your practice through dedicated teams, advanced RCM automation, and honest support.
From CPT 96413 to ICD-10 cancer codes, we handle every detail so you can focus on patient care.
Contact AccuBill Solutions LLC today to learn how our Oncology Billing Services can improve your revenue cycle and compliance across Miami and throughout the USA.