Oncology Billing Services
Oncology Medical Billing Services for Cancer Care Practices in NY, NJ & CT
Oncology billing is among the most financially consequential and compliance-sensitive specialties in all of healthcare. Every chemotherapy infusion, radiation session, and oncology office visit involves a complex interplay of drug billing, administration codes, diagnosis sequencing, and payer-specific authorization requirements. A single documentation error can result in significant recoupments, audit findings, and delayed reimbursements.
Billing Genies provides specialized oncology medical billing and RCM services to medical oncologists, radiation oncologists, hematologists, and cancer centers across New York, New Jersey, and Connecticut. Our certified oncology billing specialists bring deep expertise in chemotherapy drug billing, infusion administration rules, radiation therapy components, and the documentation standards required to withstand payer audits.
Our Oncology Billing Services
Chemotherapy Drug & Administration Billing
We handle the full complexity of chemotherapy billing — from individual drug units and national drug code documentation to administration codes for push, infusion, and injection services. Drug wastage documentation, sequential infusion rules, and concurrent drug requirements are applied correctly on every claim to ensure accurate reimbursement.
Radiation Therapy Billing
Radiation oncology billing involves distinct technical and professional components. We manage external beam radiation, intensity-modulated radiation therapy, brachytherapy, stereotactic radiosurgery, and simulation coding — ensuring modifiers are applied correctly for both the radiation oncologist and the treating facility in all billing arrangements.
Infusion & Injection Billing
Non-chemotherapy infusion and injection services — including hydration therapy, therapeutic drug infusions, and immunotherapy — require precise application of infusion hierarchy rules. We apply initial, sequential, and concurrent infusion codes correctly, preventing the systematic underpayment that results from incorrect hierarchy sequencing.
Oncology Evaluation & Management Billing
Oncology office visits require careful complexity documentation. We ensure visits for initial cancer consultations, ongoing treatment management, and survivorship care are coded to the highest defensible level based on medical decision making or total time. Chronic care management and principal care management services are captured where applicable.
Drug Prior Authorization & Appeals
Oncology prior authorizations are among the most labor-intensive in medicine. Our team manages the full authorization workflow — initial requests, peer-to-peer appeals, and step therapy documentation — for all chemotherapy agents, immunotherapy drugs, and targeted therapies. We track authorization expiration dates and renew proactively to prevent treatment delays.
Why Choose Billing Geinies for
Oncology Billing Services
AAPC-certified oncology billing specialists with expertise in chemotherapy and radiation billing rules
Infusion hierarchy rule compliance to prevent systematic underpayment on multi-drug infusion claims
Prior authorization management for all chemotherapy, immunotherapy, and targeted therapy agents
Radiation therapy technical and professional component billing for multi-entity oncology practices
Audit-ready documentation review on every oncology claim before submission
Real-time A/R tracking with denial trending by service category and payer
Real-time A/R tracking with denial trending by service category and payer
Our Process
Our Oncology Billing Process
Geographic
Serving Oncology Practices Across NY, NJ & CT
New York
New Jersey
Connecticut
New York
New York cancer centers and oncology practices operate in one of the highest-volume oncology markets in the nation. We work with oncology groups billing through the full range of NY commercial and government payers, including practices affiliated with major academic medical centers and independent oncology groups across all five boroughs.
New Jersey
New Jersey oncology practices benefit from our expertise with NJ-specific payer policies, particularly for immunotherapy and targeted therapy prior authorization requirements. We help NJ cancer centers manage the administrative burden of complex oncology billing while maintaining full compliance.
Connecticut
Connecticut oncology and hematology practices increasingly offer advanced therapies requiring specialized billing frameworks. We support CT practices with the documentation and billing processes these cutting-edge treatments require, including facility versus professional fee separation for academic and community cancer centers.
FAQs for Billing Genies
What is the infusion hierarchy rule and why does it matter in oncology billing?What does a medical billing company do?
The infusion hierarchy rule determines which service is billed as the primary code versus add-on codes when multiple infusions are administered in the same session. Incorrect hierarchy application is one of the most common causes of systematic underpayment in oncology billing. Our specialists apply these rules correctly on every claim to protect your reimbursement.
A medical billing company manages claim submissions, coding, and payments to help healthcare providers receive faster and more accurate reimbursements.
Can an office visit be billed on the same day as a chemotherapy infusion?What does a medical billing company do?
Yes, but only when the office visit involves a separately identifiable and medically necessary service beyond the infusion administration itself. The visit must be documented as a distinct service. Without clear documentation of a separately identifiable encounter, payers will bundle the visit payment into the infusion reimbursement.
A medical billing company manages claim submissions, coding, and payments to help healthcare providers receive faster and more accurate reimbursements.
How do you handle radiation therapy billing for practices with both technical and professional components?What does a medical billing company do?
When the practice owns the equipment and employs the radiation oncologist, global billing captures both components. When the physician is independent from the treating facility, we bill the professional component for the oncologist and the technical component for the facility separately — ensuring both entities are reimbursed completely.
A medical billing company manages claim submissions, coding, and payments to help healthcare providers receive faster and more accurate reimbursements.
What documentation is required for chemotherapy drug prior authorization?What does a medical billing company do?
Authorization documentation typically includes the diagnosis and disease stage, the chemotherapy regimen and clinical rationale, pathology confirmation, alignment with accepted clinical guidelines, and prior treatment history for second-line agents. Our team compiles this documentation from the clinical record and submits it proactively before treatment begins.
A medical billing company manages claim submissions, coding, and payments to help healthcare providers receive faster and more accurate reimbursements.
Do you manage billing for both medical and radiation oncology in the same practice?What does a medical billing company do?
Yes. We manage billing across all oncology subspecialties, including medical oncology, radiation oncology, hematology, and surgical oncology. Our team understands the distinct billing rules for each subspecialty and manages them under a unified revenue cycle process.
A medical billing company manages claim submissions, coding, and payments to help healthcare providers receive faster and more accurate reimbursements.
