​Navigating the complexities of radiation oncology billing is crucial for providers to ensure accurate payer contracting, claim submission, reimbursement, and compliance. This article delves into the distinctions between professional-only, technical-only, and global billing within the Hospital Outpatient Prospective Payment System (HOPPS) and the Medicare Physician Fee Schedule (MPFS) environments.

​The financial stability of oncology practices has been a growing concern as physician reimbursement rates have steadily declined over the past couple of decades largely due to conversion factor reductions, amongst other things. On January 1, 2025, the Centers for Medicare & Medicaid Services (CMS) implemented a 2.8% reduction in physician payments, intensifying financial pressures on providers and raising broader concerns about workforce sustainability and patient access to care [1]. In late January, a bipartisan bill was introduced in Congress proposing a 6.6% payment increase, effective April through December 2025, aiming to offset the effects of the recent cut and stabilize physician reimbursement [2].

Osteoarthritis (OA) affects millions worldwide, leading to chronic pain, limited mobility, and decreased quality of life. While traditional treatments such as physical therapy, medications, and surgery remain common, radiation therapy (RT) is increasingly being adopted for the treatment of osteoarthritis (OA), providing promising relief of symptoms. Though not common in the United States, the concept of low-dose radiation to treat osteoarthritis has been around for decades. Incorporating RT for OA treatment in the United States presents new opportunities for patient care and introduces complexities in oncology billing practices. ​

​Small oncology practices face immense financial pressures to maintain state-of-the-art care facilities. These challenges, compounded by the necessity to keep up with cutting-edge medical technology and manage operational costs, make it essential for small oncology practices to find effective solutions across the revenue cycle. Partnering with an oncology billing company like RC Billing can help these practices navigate the demands of modern cancer care, ensuring they remain both clinically effective and economically viable.

Claim denials in radiation oncology are more than just a financial inconvenience — they're a drain on time, resources, and efficiency.

But did you know that up to 86% of denials are preventable? We've just released a white paper that digs into the most common causes of these denials and, more importantly, how to prevent them.

Download the white paper today to learn how your practice can recover lost revenue by addressing the root causes before they cost you more.
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​Efficient billing practices are critical not just for the financial health of oncology practices but also for enhancing patient care. Streamlined billing processes reduce administrative burdens, improve financial stability, and foster a positive patient experience. ​According to a recent Healthcare Finance Management Association (HFMA) poll, revenue is the top goal for 2024, and improving the patient experience is a close second, particularly for large health systems. We have seen the same trends within individual physician private practices as well. This article explores how outsourcing billing can significantly benefit patient care and operational efficiencies in oncology practices.

Compliance in oncology billing is not just a necessity but a critical aspect of maintaining the financial health and operational integrity of an oncology practice. The landscape of oncology billing is constantly evolving, with new regulations being introduced regularly. This dynamic environment requires practices to stay vigilant and updated to avoid financial penalties and operational disruptions. Partnering with specialized billing services like RC Billing can provide oncology practices with the expertise and resources needed to navigate these changes effectively and ensure compliance. ​

In this article, we will review the key performance metrics necessary for evaluating oncology billing services and define the success of oncology billing practices. In addition to discussing the essential metrics, we will also briefly touch on practical strategies for implementing these metrics effectively within oncology practices. By understanding and applying these metrics, practices can improve their billing processes, ultimately optimizing financial health and patient care outcomes. ​

​When Mitzi Wilson first joined RC Billing nearly 20 years ago, the company had only 5 clients and less than 10 employees.
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“We’ve grown tremendously since then,” she says.

As an oncology provider, delivering high-quality clinical care to your patients is of the utmost importance, and equally significant is providing top-notch financial care for your patients. Collaborating with a specialized oncology billing service is crucial for the financial care of patients and your practice. This partnership ensures that claim submissions and any subsequent actions taken on your patients’ behalf are not only accurate but are also carried out with compassion and understanding. In this article, we will explore the distinctive advantages of engaging with an oncology billing company and guide the key considerations when selecting an oncology billing service before committing to a contract.

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