Medical and Radiation Oncology Consulting

Maintaining the business health of your oncology practice in the face of medical industry stresses

Innovations in medical technologies promise to help healthcare providers treat a broader range of medical conditions, but each advance adds complexity to billing and reimbursement processes and operations management at hospital-based and freestanding oncology centers. The workload can be overwhelming for oncology-practice business professionals, especially if business operations are performed by the practice’s physician. The effect? Many centers struggle to stay in step with the latest practices—and in compliance with federal regulations.

Amidst healthcare reforms, and ever-changing reimbursement policies, today’s radiation and medical oncologists need practical, expert help to perform the critical business operations and maintain the financial strength of their practices.

Employing expert consulting services

The business of managing a medical and radiation oncology practice is multifaceted. Radiation and medical oncology center managers must have broad knowledge encompassing human resource (HR) management, budgeting, program planning, oncology coding, oncology billing and reimbursement, cancer treatment center development, managed care, and general operations. And the demands on medical business professionals are equally high whether they represent private-practice or hospital-based radiation and medical oncology centers.

While physicians are responsible for patient care, the treatment center’s business staff must provide support for the billing and reimbursement routine that generates revenue, enabling the medical staff to provide healthcare services.

The larger the practice, the more complex the billing, reimbursement, and day-to-day operational processes may be. Increasingly, radiation and oncology centers are looking for cost-effective ways to meet their critical business needs—without adding full-time staff.

The solution? Leveraging the expertise of a comprehensive business-management consulting partner whose advisors understand the unique needs and challenges of oncology care services.

Consultants at leading oncology-practice solutions companies can provide expert guidance to help streamline your medical and radiation oncology billing and reimbursement practice to cut operational costs, maintain compliance with government regulations to reduce risk, and improve your profitability by capturing more revenue.

The audit: Gain insights to improve your bottom line

A credible consulting partner may recommend an audit of your practice from a business perspective. By conducting a thorough audit, your consultant can help ensure that your entire practice is in compliance with federal regulations that govern medical and radiation oncology reimbursement. Typically, a consulting company’s experts will evaluate:

  • how accurately you capture charges for services to determine revenue opportunities
  • how well you maintain compliance standards to assess risk potential
  • your process, to identify inefficiencies and solutions

When beneficial, experts conduct audits on-site at your hospital-based or freestanding center. With your oversight to safeguard patient privacy, the audit team will carefully examine a small set of patient records to verify billing accuracy. The audit compares all procedural documentation to charge-capture records.

In addition, consultants may recommend training to help your medical and billing-department staffs learn and implement best practices to streamline operations. The goal? More accurate claims, and less time to reimbursement, improving your revenue stream.

The key is finding an oncology business-management solutions partner with rich expertise in radiation and medical oncology to effectively train your staff. To compare and qualify potential consulting partners, look for providers with clinical experience in billing and reimbursement practices supporting such procedures as IMRT, chemotherapy administration, chemotherapy drugs, brachytherapy and other specialty services.

The paperless practice: Complying with federal initiatives

In early 2004, the federal government publicly urged the medical industry to begin converting patients’ medical records from paper to digital formats, with the ambitious goal of creating electronic health records (EHRs) for most Americans by 2014. Today, that effort is under way but the process of electronic medical record (EMR) conversion can be tedious and costly. And healthcare providers aren’t all taking the same approach, creating an array of EHR formats across the industry.

By enlisting the guidance of a consulting partner with billing and coding expertise, you can help speed and ease the EMR conversion process at your facility. For example, your billing consulting partner can help make sure your patient records have consistent coding so that all records are compatible with billing and coding systems—helping you reduce the time it takes to prepare patient bills. The result? You can get paid faster. Electronic documentation is also more likely to satisfy clinical and payer reviews, saving your staff critical time at work.

Like many oncology departments today, you may have already purchased the software to create EMRs, but your staff may lack the training and time to use the technology efficiently. You may not be realizing the value of your EHR software investment. Your consulting partner’s billing and reimbursement policy experts can help you fully understand and utilize your software tools to speed the conversion process and ensure compliance with payer guidelines.

Operating under pressure without breaking a sweat

You’ve addressed the complexities of government regulations with standards-based processes, industry best practices, and a well-trained medical staff. You’ve embraced new technologies to keep in-step with an increasingly digital industry. And you’ve tackled reimbursement issues with clear payer and patient policies. The foundation is in place; now you have a radiation and medical oncology practice to run. Efficiency is key. If your business isn’t running smoothly, your medical and office staff can’t adequately support your patient care services.

Your radiation and medical oncology consulting partner should be able to provide experienced, on-site, interim management to help you improve daily operations—especially while you’re training new staff or adjusting to increased workloads.

When you compare radiation and medical oncology consulting companies, be sure to compare whether they provide:

  • staff education and training
  • staff-management services
  • oversight reports to your hospital-based or private-practice administrators
  • oncology billing and compliance review
  • long-term management solutions (coordinated with your HR team)

The business of managing a medical and radiation oncology practice can be challenging, time consuming, and costly. The larger your practice, the more complex your billing, reimbursement, and day-to-day operational processes may be. You need cost-effective ways to meet operational needs—without adding full-time staff.

Leverage the expertise of a qualified oncology-solutions business-management consulting partner whose advisors understand the unique needs and challenges of oncology care services.



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