Don’t Lose Money With Radiation Medical Billing

You could be losing money on radiation treatment therapy if you don’t do your medical billing correctly. Did you know that you could lose out on over $100 if you miss one radiation therapy reimbursement. A great medical billing skill is knowing how to maximize your revenue with radiation therapy.

Radiation is a type of treatment that is frequently done two or even three times a day. It is a perfectly acceptable medical billing practice to bill separately for radiation completed on the same day. It is important, however, to pay attention to the medical billing requirements set forth by the payers.

Many payers require a certain amount of time in between occurrences to bill separately for 77401 and 77416. The common time frame for separate medical billing reimbursement is six hours if there are two treatment. If you need to do medical billing for three different treatments in one day, four hours is the norm.

There are instances when a physician orders radiation treatment to be done on the same day and four to six hours does not separate the occurrences. If the insurance company or Medicare denies this claim, don’t go down without a fight. If your physician can produce a letter of medical necessity with your medical billing, you will have a good shot for reimbursement. Payers are not out to get you, they just don’t want to pay for unnecessary services.

Before getting denied on your radiation therapy claims, be sure to send in all the necessary documentation with your medical billing. Failure to do so will lead to a long turn around time and more cost to you per claim. Teaching your medical billing staff the correct way to bill for radiation therapy is in your best interests.

View all Articles by: Melissa Clark, CCS-P