RO Model Billing
The Problem Defined
The Radiation Oncology model is complicated. Radiation Therapy participants will need to invest into education. Study enough and you will master it. However, just because you understand it, does not mean you can easily implement it. It changes the workflow of patient billing and requires a great deal more human intervention. This is challenge enough, but the additional problem is that it changes the workflow inconsistently. Even if you are a participating provider, that does not mean you get to abandon Fee-For-Service. Some patients are billed with RO Model, others will not be. Those billed with RO Model still need to be simultaneously billed Fee-For-Service. Even within the pool of patients that fit into the basic qualifications, some patients must be billed as Exception episodes using the GB modifiers. It is not simple and even if you create clear procedures it likely doubles the administrative workload. Mistakes will be costly. In FFS, if you bill a code incorrectly, you could potentially lose reimbursement on that service. In RO Model, if you bill incorrectly, you may lose reimbursement on the entire episode. As Radiation Oncology revenue cycle management specialists, Shavara Inc. has developed a solution that eases the burden. Our medical billing software, Iridium Suite, features a workflow oriented solution that automates a great deal of the process and makes sure you don’t bill incorrectly or forget when to bill. Read more about that RO Model solution here or sign up for a demo to see it yourself:
