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Oncology billing complexity meets cutting-edge expertise through compliant Oncology Billing services.

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Oncology billing complexity

Rapid Revenue Recovery

0 Days

Revenue Increase

0 %

Denial & Rejection

5 5 %- 10 %

Short Turnaround Time


Electronic Claim

0 %

Electronic Payment

0 %

Client Retention


First-Pass Resolution

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Our Oncology billing team always thinks ahead

Certified and Well-Trained Coders and Billers

Our team is comprised of certified and well-trained coders and billers, each of whom brings a high level of expertise and knowledge to our services. 

E/M Coding in Oncology

Our team has extensive experience in navigating the specialty requirements of the electronic health record systems of oncology practices. We understand the unique challenges these systems pose, such as the need for specific codes for different types of treatments.

Elaborate Codes for New Anti-Cancer Therapies

We understand the complex targeted therapy, immunotherapy, and other advanced treatments from oncologic services.

MACRA Compliance

Our team stays updated on the continually changing regulations and the ever-emerging requirements of MACRA, a crucial aspect of oncology billing services. We ensure your oncology practice complies with these regulations, giving you peace of mind and allowing you to focus on patient care.

Our Oncology billing team always thinks ahead
Advanced specialization in oncology coding

Expert Oversight for Enhanced Revenue Outcomes

This magnitude of knowledge and expertise puts us in a place to know and rectify any flaws within your billing system resulting in better revenue outcomes and revenue gains for your practice.

Serving oncologies in the US



First Pass Resolutions for Oncology Practices in the US



Revenue increase for Oncology Healthcare Provider



Denials for Oncology Healthcare Provider in the US


5% - 10%

Navigating the ever-changing world of Oncology Billing

Our oncology billing department is extensive and keen on accuracy in their work. We understand the never-ending list of codes and modifiers published by CMS for any oncology billing. We ensure that every possible HIPAA compliance is provided in the oncology billing for an increased claim acceptance and a high degree of first-pass resolution rates. Inpatient billing and outpatient billing are worlds of difference in procedures such as chemotherapy administration.

changing world of oncology billing

Outsource Oncology Billing Services to optimize Revenue through our Oncology Revenue Cycle Management in the U.S.

From Oncology Billing Solutions to Oncology Denial Management, Pro Medical Billing Solutions empowers offer affordably
Oncology Billing Services to the Oncology healthcare providers in the U.S.

Our comprehensive approach starts with a thorough assessment of your existing billing process.

We delve deep into your billing records, identify latent issues such as under-coding or over coding, missed charges, or incorrect use of modifiers. We then implement tailored solutions to address these issues and turn those opportunities into revenue, ensuring a more efficient and accurate billing process for your practice.
Our specialized billing services handle complex treatments, such as stem cell transplants, as they ensure that pre-authorization for the treatment is available for smooth processing and reimbursement.
Our detailed approach enables your oncology practice to expect accuracy in coding and timely reimbursements that will help minimize errors and maximize potential revenue.
Benefit from our experience working with top oncology institutions as we design solutions in billing that would tune directly into your revenue cycle and latent issues that need identification for enhanced profitability.
We shall start with a comprehensive analysis of your existing billing process and point out areas where you can enhance the same, along with the implementation of permanent solutions. These enhancements, in turn, are likely to earn you an increase in revenue to your practice and ensure success.

The ever-changing landscape of oncology treatments presents a constant challenge for billing accuracy.

With new therapies and evolving protocols emerging regularly, the complexity of Oncology Medical Billing Services increases. Busy oncologists often need more time or means to keep up with the regular oncology billing and coding updates, which usually creates a significant risk of under-coding or over-coding services. Routine procedures, like administering chemotherapy, planning radiation therapy, and even targeted therapies, are highly demanding to code. A significant reduction in Oncology Practice Revenue is likely to occur if there are any errors in the services of radiation oncology billing:

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Dynamic Oncology Treatment Challenges Billing Accuracy
Outsource Radiation Oncology

Advanced specialization in oncology coding

Rest assured, our team remains current with the latest oncology coding standards, such as ICD-10-CM, CPT, and HCPCS. They are well-versed in revenue cycle radiation oncology billing and ensure your claims are in compliance with CMS and AMA guidelines to the last letter. All of our coders are AAPC-certified, assuring the quality and proficiency of our services.

Outsource Radiation Oncology Billing Services for :

With our oncology billing experts, the complexity of handling complex radiation oncology billing and coding is eliminated. We have a systematic approach that simplifies these codes, ensuring accurate billing and maximum reimbursement for your practice.
By outsourcing your oncology billing services to our experts, you can be confident that there will be no wrong coding and that you will receive maximum reimbursement, leading to better revenue recovery for your practice.
You can focus on patient care while we handle the complexities of oncology billing.
Experience seamless coordination between your practice and our team, ensuring clarity and efficiency in all billing matters.
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Statistics That Define Our Company


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Claim Acceptance rate

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Frequently Asked Questions

We’ve have compiled a list of commonly asked questions to provide you with quick and informative anwers.

Use appropriate E/M (Evaluation and Management) codes with modifiers to reflect the increased complexity of oncology consultations, treatment planning, and coordination. Document the time spent on these activities meticulously. Consider using add-on codes for prolonged services if necessary.
For new treatments without specific codes, bill using appropriate unlisted service codes with detailed documentation justifying the service and its medical necessity. Stay updated on HCPCS (Healthcare Common Procedure Coding System) updates for potential new code assignments.
Understand the bundled payment model for your specific oncology care. It may require bundling multiple services into a single payment. Collaborate with your billing team to ensure accurate coding and capture all services provided within the bundle.
Bill oral chemotherapy drugs using specific J-codes and modifiers. Identify and bill separately for supportive medications using appropriate HCPCS codes.
Use specific codes for genetic testing procedures and counseling services. Ensure proper documentation linking the test to the patient’s cancer risk assessment.
Use the designated POS code based on the location where the service is delivered. For example, use code 11 (Office) for outpatient clinic visits and code 22 (Inpatient Hospital) for services rendered during hospitalization.
Familiarize yourself with relevant oncology-specific modifiers like 25 (Significant additional overdue service) or 59 (Distinct procedural service). Use appropriate modifiers to accurately reflect the variations in procedures performed during your oncology practice.
Work with your billing team to understand prior authorization requirements for specific oncology services. Appeal denied claims with clear and detailed documentation supporting medical necessity.
Maintain thorough and detailed documentation for all oncology services. This includes the complexity of the case, time spent, treatment plan, and justification for all services rendered.
Stay updated on oncology billing regulations and coding updates. Implement a strong internal compliance program to minimize errors and prepare for potential audits. Consider partnering with a qualified oncology billing specialist for additional guidance.

Our Solutions

Our advanced Infrastructure and Strategies are designed to determine issues in your Revenue Cycle Management and improve them with precisely streamlined processes. We recognize that healthcare providers face a variety of challenges, including missed charges, under pricing, non-reimbursed errors, coding errors, and more, which can lead to significant revenue loss each year.

Therefore, we have designed our Medical Billing & Coding Services as well as Physician Credentialing to prevent any discrepancies and provide accurate deliverables, ultimately helping healthcare providers achieve optimal Revenue generation


Medical Billing & Coding Services


Physicians Credentialing Services


Revenue Cycle Management


AR & Denial Management Services


Medical Billing and Coding Audit


Verification & Prior Authorization


Ambulatory Surgical Center Billing


Contact Center & Patient Scheduling

We're here to help

We're available 24/7 - Schedule a call with one of our experts now.

Free Billing Audit

Medical Billing Software We Leverage for Revenue Cycle Management

Here are some Industry top listed EHR being operated by us.

Our Esteemed Clients' Testimonials

Pro Medical Billing Solutions is doing an incredible job of boosting our revenue and improving our cash flow. They are excellent at communicating with the insurance providers and are prompt in addressing issues. We're immensely grateful for their wonderful efforts, and we give a thumbs-up to their entire team.

Dr. Jorge Guevara - MD
Dr. Jorge Guevara | MD Outcomes Detox & Recovery Center (Texas)