Our Comprehensive Proton Therapy Billing Solution

Proton therapy is one of the most advanced and heavily scrutinized modalities in cancer treatment.

​At RC Billing, we’ve spent decades navigating the billing, coding, and authorization challenges that come with proton therapy. As part of our full-service radiation oncology billing model, we bring the experience and processes needed to protect your revenue and manage your claims with precision.

Charge Entry & Daily Claim Submission

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• Daily charge processing via required HL7 ADT and DFT interfaces 
• Daily claim scrubbing to assist with resolution to front end edit denials prior to claim submission to the payer 
• Daily claim submission to enhance cash flow 

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Denial Management & Appeals

​Proton therapy denials are among the most complex in oncology, often categorized by payers as not medically necessary or investigational/experimental. The high-dollar value of proton treatment makes every denial critical. Our oncology-trained AR team aggressively follows through until resolution:

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• Appeals tailored to proton-specific denial reasons with supporting clinical evidence and payer policy citations
• Custom appeal letters and medical necessity documentation obtained from physicians
• Escalation through all payer appeal levels, including external reviews when available
• Root cause analysis to identify and prevent recurring proton-related denials
• Proven history of recovering hundreds of thousands in revenue per case—even after years of payer resistance
• Oncology-trained denial team experienced in overturning proton therapy denials
• Tracking trends across commercial and Medicare/Medicaid plans

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Cash Application & Financial Reconciliation

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• Line-item receipt posting and contractual adjustment tracking
• Line-item denial posting
• Secondary billing and follow-up
• Monthly financial reporting packages and review calls

Specialized Add-On Support

Proton therapy billing is only as strong as the prep work behind it. RC Billing offers two targeted services that help prevent denials and cash delays from the start:

Prior Authorization Management
Prior Authorization Management is available as a standalone or billing add-on service
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Proton prior authorizations are highly detailed, requiring procedure code-level approvals based on medical necessity and precise unit tracking. Missing a single code or unit can result in complete nonpayment. Our team:

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     → Reviews treatment plans and supporting documentation
     → Submits complete prior authorization requests with all necessary procedure codes
     → Tracks payer responses and appeals prior authorization denials 

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Payer Credentialing & Contracting
Payer Credentialing & Contracting is only available as an add-on to full-service billing clients
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Launching or expanding a proton program requires payer credentialing and proton-specific contract provisions. We help with:

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     → Enrollment and contract support for radiation oncologists
     → Support with payer contract negotiations or renegotiations to ensure reimbursement                reflects the complexity and resource demands of proton therapy.

Explore Add-On Services →

​Why Choose RC Billing for Proton Therapy Billing?

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• Expertise: Our team has extensive proton therapy billing expertise, understanding the intricacies of this complex radiation treatment modality.
• Comprehensive Support: We provide end-to-end revenue cycle support—from prior authorization to denial appeals.
• Compliance: We partner with clients providing guidance regarding medical record documentation requirements and offer payer strategy guidance.
• Advocacy: Our CEO, Ron DiGiaimo, is actively involved in congressional reimbursement reform efforts for proton therapy treatment in Washington, DC. 

When you partner with RC Billing, you gain more than a billing service. You gain a trusted advisor with the expertise to support your proton therapy program with confidence and precision. 

RC Billing undergoes an annual SSAE 18 SOC 1 Type 2 audit and HIPAA compliance risk assessment to validate our internal controls and data security. When you partner with us, you can trust your practice is supported by a billing company that holds itself to the same compliance standards we expect from clients.

Let’s work together →

Let's Build a Better Billing Process for Proton Therapy

RC Billing is your ally in protecting revenue, reducing denials, and keeping your proton program financially strong.

Learn More About Who We partner with

Our Full-Service Billing Solution →