About Revenue Management and Oncology Billing Services
OCI’s revenue management is designed specifically for the challenges of oncology reimbursement. We perform typical billing services, such as processing and appealing claims. But, just as importantly, we analyze all areas of the business, front-to-back, to advise our clients on how to best maximize revenue.
We customize our services around the needs and expectations of each individual client. As a result, our level of involvement in our clients’ daily needs varies depending on those needs and expectations.
OCI believes it is very important that our clients can see their billing data when they want to. For that reason, our clients can view their data at any time via a secure link to our client portal. OCI also provides state of the art reporting and decision support tools that allow our clients to make real time decisions about their practice and not just react to old data.
Oncology Revenue Recovery
OCI’s Revenue Recovery service is a four-step process designed to identify clients’ billing irregularities that resulted in an under and/or overbilling event. The steps begin with a software scan of all billing data followed by intense analysis, review and verification of all events identified by the software algorithms. OCI does a majority of the work so as not to burden our clients with time-consuming projects. Any missed reimbursements OCI finds are prepared with proper verification documentation in a turnkey product ready to be submitted to insurance providers.
In a typical audit, an adviser works onsite to review 20-30 actual patient charts and from those charts, determines whether a practice is billing services in a compliant and efficient manner. Since the auditor only looks at a small percentage of charts, they may miss some patterns that would be caught in a larger sample, and any missed reimbursements will have to be found later by the practice’s own billing personnel. OCI’s Revenue Recovery examines all billing data, finding every anomaly that resulted in an under or overbilled event. All patterns are caught so that our analysts can advise on how to maximize reimbursements going forward. Consequently, Revenue Recovery provides a thorough and complete review of all billing data, while a typical audit is a small sample of charts.
Revenue Recovery is a contingency-based service that charges a percentage on identified and collected unbilled charges as well as on opportunities found. There are no “hidden” fees.
Overbills are increasingly under close scrutiny by CMS in the form of RAC Audits. Recovery Audit Contractors are paid a percentage of overbills they find, so it is to their benefit to identify every possible time CMS has been overcharged. Since OCI’s Revenue Recovery provides a complete analysis of all billing data, we can identify non-compliant patterns and procedures that would be caught by a RAC auditor. Armed with that information, your office can adopt more compliant procedures before it becomes a target of a RAC audit.