US Oncology Launches Oncology-Specific Billing and Reimbursement Service
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With a focus on maximizing key reimbursement metrics, ORS offers a comprehensive revenue cycle management program, a full curriculum of oncology billing and coding education, and assistance in accessing patient assistance programs.
The stand-alone service provides oncologists with unparalleled expertise in revenue cycle management to ensure proper reimbursement for their services. As a leader in oncology business operations, US Oncology has an experienced reimbursement team that supports the billing processes for over 1,000 oncology providers in more than 325 sites of service across the nation. The US Oncology reimbursement team oversees approximately $8 billion in gross patient revenue each year. ORS leverages this vast experience to offer services that support all critical front and back office activities of a practice.
“In today’s complex and evolving oncology reimbursement landscape, oncologists require a comprehensive revenue cycle management solution designed specifically for their practices,” said Karen Pilley, vice president of Reimbursement Solutions for US Oncology. “ORS expertly meets that need by providing support through proven operational processes, state-of-the-art technology, and US Oncology’s unparalleled oncology reimbursement expertise.”
US Oncology has customized the ORS practice management system to specifically meet the complex needs of oncologists. Understanding the need for an integrated revenue cycle model, the ORS technology solution supports both front and back office business functions. Benefits of the technology include efficient scheduling models; integrated claim scrubbing; payer contract management; a virtually paperless accounts receivable and denial management process; and advanced reporting and analytics.
Payer contract management helps ensure accurate and timely payments through monitoring of contractual rates and fee schedules. Under the ORS model, overpayments or underpayments are identified at the time of cash posting. Proper contract management helps practices reduce write-offs of collectible revenue and apply EOB audit processes on all new and existing contracts.
Proper denial management is critical in creating an efficient revenue cycle process. The ORS team identifies the source of any issues and determines a recommended plan of action. Whether working with the practice to put proper front office procedures in place or working complex denials with payers, ORS aims to resolve the source of the denial.
“The goal of ORS is to make sure we resolve the reasons claims are denied in the first place,” said Karen Pilley. “With our advanced technology solution, we have the ability to write claim edits and increase our claim scrubber functionality. This means the claims have a greater likelihood of being approved the first time they are submitted.”
ORS also offers valuable billing and coding education for practice staff. Resources include a web-based library featuring articles on coding updates and reimbursement operational best practices; audio conference and webcast education; billing, coding and E/M educational tutorials; and a field team available for state-specific reimbursement needs.
Another service feature is the ORS Patient Assistance Support team. This team works with national foundations to help secure funding for financially qualified patients who cannot afford their coinsurance for oncology treatments. They help patients navigate the national assistance programs available to them, providing support in the application, follow-up and processing steps. By acting as an extension of the practices, ORS Patient Assistance Support also works with drug manufacturers to help patients without insurance obtain oncology drugs at no cost or very low cost. At the request of practices affiliated with US Oncology, the experienced ORS Patient Assistance Support team secured over $14 million in funding in 2007 for cancer patients in need.
About US Oncology, Inc.
US Oncology, headquartered in Houston, works closely with physicians, manufacturers and payers to identify and deliver innovative services that enhance patient access to advanced cancer care. US Oncology supports one of the nation’s foremost cancer treatment and research networks accelerating the availability and use of evidence-based medicine and shared best practices.
US Oncology’s expertise in supporting every aspect of the cancer care delivery system — from drug development to treatment and outcomes measurement, enables the company to help increase the efficiency and safety of cancer care. According to the company’s last quarterly earnings report, US Oncology is affiliated with 1,247 physicians operating in 472 locations, including 91 radiation oncology facilities in 39 states. For more information, visit the company’s Web site, http://www.usoncology.com/.
SOURCEÂ US Oncology, Inc.
