Oncology Billing

Yes. All coding is performed by certified coders, and specialty assignment is deliberate rather than incidental — drug billing by NDC and units alongside administration codes, where a units error is immediately expensive.

Three causes account for most of it: drug units miscalculated against the NDC; authorization not in place before infusion; administration codes billed without hierarchy. Each is a documentation or process failure rather than a coverage dispute, which is why we report denials grouped by cause instead of as a single rate.

Specialty-drug authorization is the gating step for most treatment, and peer-to-peer review is routine rather than exceptional. That shapes which denials are worth appealing and where the front-end effort should sit, so it drives how we staff the work rather than being background color.

No. Payment is decided by the payer, and any firm promising a collection rate is describing something it does not control. We commit to the process and to six reported numbers you can check against your own system.

Codes are assigned from the documentation the practice provides, and where the record does not support a code we raise a query rather than infer intent. The clinical record and the certification of medical necessity remain the practice's, and claims go out under the provider's own National Provider Identifier.