- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Onco-billing represents one of the most challenging forms of medical billing in terms of the complexity involved. Clinics are losing between 3% to 7% of their revenue due to denials, under-coding, and poor management of drug wastage. Stream RCM can increase revenue by 7.2%, decrease claim denials by 42%, and speed up payments by 18 days.
We code immunotherapy, targeted therapy, and chemotherapy with 99.2% accuracy. Dose intensity and infusion time units are confirmed, along with use of proper codes for chemotherapy administration (96413, 96415). We guarantee a decrease in chemotherapy denials by 38%.
Our billing process covers all the complicated fraction-related billing, which includes the codes 77427 and 77301. The charge capture auditing process we follow helps us to identify each unit of treatment, helping us improve revenue in radiation oncology by 31%.
Accurate coding of tumor excisions, mastectomy, and lymphadenectomy with strong ICD-10 linkages that can help to decrease the clinical validation denial rate by 44%. We make sure that every surgical case is properly coded.
Our expertise lies in NDC capturing, billing of drug waste using JW and JZ modifiers, and billing of supportive medications. The systematic process that we follow helps us gain an extra 29% revenue from drug-based claims.
Blood cancer billing requires many frequent laboratory pairings guidelines and bone marrow biopsy documentation requirements. We use the CMS bundling edits that prevent from ever submitting 85025 and 85027 codes together. As a result, our edits decrease hematology denials to 36%.
Stream RCM provides comprehensive revenue cycle management services specifically designed for oncology practices.
Our specialized team of denial management experts appeals denied claims using payer-specific approaches and recovers 42% of all denied claims. We target high-cost revenue immunotherapy claims and drug-related denied claims to reduce our write-offs by 35%.
We pursue older accounts that fall into the 60–120+ day categories through rigorous account collection procedures that have helped reduce the average number of days outstanding to 18 fewer days. Our process has enabled us to lower balances by 32%.
Audit checks reveal missed E/M services, prolonged care codes such as G2212, and wasted drugs without billing. Our comprehensive audit process identifies underbilled charges systematically to generate additional 27% revenue.
Our Certified coders having oncology expertise confirm proper CPT, ICD-10, and HCPCS selection. We check documentation compliance with NCCN, which helps to reduce clinical validation denials by 44%.
We take care of enrolling payers, re-validating and negotiating contracts to make sure your practice stays in network with all major carriers. With our credentialing services, we can reduce enrollment delays up to 53%.
Payment Posting with Reconciliation of EOBs to contracts, detecting underpayments and ensuring proper adjustment. Our average rate of recovery of underpaid claims is 4.2% using proper contract validation and appeals procedures.
Schedule your free, no-obligation revenue audit and see exactly how much Stream RCM can recover for your oncology practice.
Oncology practices that outsource to a specialist like Stream RCM see a 37% reduction in administrative overhead and a 28% increase in net collections. Our extensive knowledge in drug pricing, infusion coding, and payer guidelines means we can reduce the expensive mistakes made by in-house practices. Studies indicate that 80% of medical claims contain errors, especially oncology bills due to the complex regimen and coding changes. Our collaboration means you can reclaim 15-20 hours of staff time each week to focus on prior authorizations, patient navigation, and clinical skills. We give you 24/7 dashboard analytics so you can get all the information on your revenue cycle process. We have specialized knowledge to deliver you results in terms of improved clean claims rate, fewer denials, and better revenue generation. We guarantee that our clinical staff is updated through training.
Stream RCM ensures precise cross-coding for these high-value, high-risk oncology codes with proven accuracy rates.
| CPT / HCPCS | Our Approach & Results |
|---|---|
| J9045 (Bevacizumab 10 mg) | We use the JW modifier for wastage, maintain NDC numbers, and confirm the proper dose entry; this prevents 41% of denials. We systematically verify all billable units of this expensive medication. |
| J9312 (Rituximab 10 mg) | Our team checks the linkage of ICD-10 codes such as C83.0 and validates the prior authorization process, which avoids 70% of denials that typically occur. |
| 96413 (Chemo Infusion 1h) | Time-based hierarchy and codes such as 96415 for extended infusion are applied, allowing us to increase revenue by 33% through time documentation and proper code selection. |
| 99215 + G2212 | We code the extended E/M visits using G2212, thereby generating additional income for our complicated oncology patients by keeping an efficient record of their time. |
| G0181 (Care Plan Oversight) | Non-face-to-face coordination is measured, and our company generates 41% additional revenue from documenting care plans oversight activities for complex oncology patients. |
One of the latest changes in the field of oncology billing for 2026 concerns the billing of radiation therapy procedures. A number of codes frequently used, such as 77385, 77386, and 77014 have been deleted. Instead of coding claims for radiation therapy based on the method used, claims will be coded depending on the level of the complexity of the treatment performed. In other words, proper documentation is needed to prove the complexity of the case. Failing to follow this change might result in low payment or denial of the claim. We have already made adjustments to the charge capture forms and billing process to guarantee the correct coding of radiation oncology claims.
Our billing services integrate seamlessly with your EMR or EHR systems to facilitate appropriate data transfer and claim processing.
The cost of drugs constitutes 60–70% of an oncology practice’s revenue, making accurate drug billing essential. Inaccuracies like using wrong NDC codes, wrong J-codes or omission of drug wastages could result in loss of money and declined claim submissions. We guarantee that all drugs are coded correctly with the help of our highly experienced coders, who code each and every drug correctly and record the correct dosage and wastages. Our experts have achieved 99.4% accuracy in drug billing. We also reduce drug denials by 38% and help you increase your reimbursements through 340B pricing and manufacturer copay assistance program identifications.
Our expert team provides targeted solutions to the biggest revenue threats in oncology with proven results.
We offer oncology billing expertise to confirm the right claims submission, fast payment collection, and minimum claim rejections.
We work on the behalf of our oncology clients to help them comply with payer policies and regulations to reduce the risk of an audit.
We guarantee quick submission and follow-up for claims to help our clients collect payments faster.
We ensure transparency by communicating the claims process to patients to understand their billing information.
We have experienced oncology billing specialists who know how to code and get paid.
We combine oncology-specific certifications, proactive denial prevention, and a dedicated drug billing team. Our clean claim rate and denial reduction are unmatched in the industry.
We meticulously document waste (JW modifier), maintain logs, and track NDC numbers. Our team recovers significant revenue per provider annually from drug waste claims.
Absolutely. Our prior authorization specialists handle all payers, tracking expirations and renewing authorization proactively. We reduce authorization-related denials by 64%.
On average, oncology practices recover 7.2% of previously lost revenue within the first 90 days of partnering with us.
Yes. Our coding and billing practices adhere strictly to CMS, NCCN, and OIG standards. We conduct internal audits to ensure defensible documentation and ethical billing.
Talk to our oncology billing team about your current denial rate and revenue goals.
