A/R Follow up for your Oncology practice

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A/R Follow up for your Oncology practice
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• Despite the increase in demand for oncology
  services, yet the practice sees a significant
  shortage of practitioners.
• Key regulatory considerations, declining
  reimbursement rates, rising operating and capital
  costs, rising cancer drug prices, emphasis on
  Value based Performance Fee all these factors
  appear to have affected the practice of
  oncologists.
• The ability to provide quality care
  simultaneously maintaining reasonable operating
  margins and improve efficiency has become
  unsustainable.

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• Simple solutions and steps put into practice will
  help make your Oncology practice more cost
  effective and also increase the reimbursements
  making the A/R process more accountable and
  reduce claim rejections and/or denials
• Ensure Check insurance eligibility on every
  visit ensuring patient's insurance is active.
•  
• If In-house or outsourcing of your claims
  process- ensure that all bills are sent out
  regularly. Remember that if you bill insurance
  just once a week, and patients just once a month,
  slows cash flow.
• Inventory Controlling drug inventory is
  important. Due to decreasing profit margins in
  chemotherapy, and other oncology services, the
  need to maintain check on the inventory is very
  essential.

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4. Internal Audit This ensures that compliances
are met and oncology coding billing processes
and workflows are being done effectively and gaps
can be addressed.   5. Documentation
Documentation should comply with Centers for
Medicare and Medicaid Services guidelines, very
essential for proof when claims are denied and/or
rejected which can affect the A/R process.   6.
A/R Reporting This is the most important to the
Reimbursement process. Understanding and tracking
of pending insurance accounts, shifts in number
of patients, etc, will help make changes in your
processes and workflows and also plug gaps and
understanding new trends.
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If you need to focus on your patients, given the
value based performance fee schedule that has
been introduced, then the claims process that
includes A/R follows, which can be very time
consuming and increase your operational costs,
should be outsourced to competent vendors. A lot
of money is often lost over the table when A/R
follows are not pursued with diligence.
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