New Bedford Blog: Improve Your Revenue Cycle Management

The radiation oncology encounter form grew to be a ubiquitous aspect of billing and collections. The forms were used to document services rendered by capturing the diagnosis and procedure codes, which served as the basis for billing and receipt of payment for services.  There were a lot of reasons the forms existed for so long.  Notably, they:

The Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive for physicians and other eligible clinicians.  MACRA is designed to provide incentives for value and improved outcomes through either the Merit-based Incentive Payment System (MIPS) or the Advanced Alternative Payment Models (APMs).

The past few years have been favorable for Radiation Oncology compensation.  Modern Healthcare’s 23^rd annual Physician Compensation Survey, reaching 6,550 healthcare organizations and nearly 346,000 physicians, found in 2016:

The provision of The Health Insurance Portability and Accountability Act (HIPAA) Omnibus Final Rule that has generated the most discussion is the elimination of the “risk of harm” standard for breach notification. The breach notification regulations did not change, however the breach notification trigger changed substantially. 

Prior authorization is the requirement to obtain prior approval for the reimbursement of medical services, procedures, tests and specialist appointments.  An increase in prior authorization requirements in radiation therapy is placing administrative and financial burdens on many radiation oncology practices throughout the United States.  Some basics that radiation oncology providers should know include:

What are the Physician Supervision Levels?

Your Radiation Oncology Coder Needs to Decide:  Simple, Intermediate, or Complex?

ASTRO’s Nine Elements of Clinical Treatment Planning Documentation for Optimum Coding