Oncology billing software, specialty by specialty.
Iridium Suite is one system, but the rules that cost a practice money are different in every specialty. Here is each one side by side: what goes wrong, and what the software does about it.
| Billing problem | Radiation oncologyShavara on radiation oncology ↗ | Medical oncologyShavara on medical oncology ↗ | UrologyShavara on urology ↗ | NephrologyShavara on nephrology ↗ | Billing companiesShavara on billing companies ↗ |
|---|---|---|---|---|---|
| Global, professional or technical?The same code pays very differently depending on who owns the equipment and where the service was done. | Site-of-service billing picks global, 26 or TC from the treatment location, so a hospital-based course produces professional lines and no delivery line. | Not usually an issue in medical oncology | Facility Track chooses the component for in-office imaging and urodynamics from where the service was performed. | Not usually an issue in nephrology | The same site-of-service rules run on every client practice's claims, so a new oncology or urology client doesn't need a new process. |
| Counting services across a courseSome services are billed by count, by course or by month, not one per visit. | The scrubber counts fractions from the Record & Verify import and flags a 77427 that is early, late or duplicated before the claim goes out. | Each authorization counts down the approved treatments, and the biller is reminded before the last approved cycle is used. | Bundling edits flag a routine visit billed inside a 90-day global period; account notes record why an exception applies. | The treatment-course workflow keeps the diagnosis on the patient for the whole course and lists every patient under treatment. | Not usually an issue in billing companies |
| Drug units and wastageDrugs are billed by the HCPCS unit, not the vial, and discarded drug needs its own modifier. | Not usually an issue in radiation oncology | Configurable checks on drug units and on the JW and JZ modifiers, plus rules that tie each drug to the diagnoses a payer covers it for. | Unit and wastage checks for the hormone injections and intravesical drugs you stock, with the administration code on its own line. | Not usually an issue in nephrology | Not usually an issue in billing companies |
| Services on the same dayTwo services on one date are often bundled, or need a modifier to be paid separately. | Simulation, planning, delivery (77402, 77407, 77412) and image guidance each carry payer-specific frequency and bundling rules in the scrubber. | CCI and payer edits for the administration hierarchy: one initial 96413 per encounter, with hydration and other infusions as add-ons. | A pop-up warns when an office visit and a procedure on the same day need modifier 25, or can't be billed together. | Every line is checked against CCI edits, payer rules, code conflicts and pre-authorization as it is entered. | The scrubber runs as each line is entered, so the correction happens on the first touch, not after a clearinghouse rejection. |
| Getting charges in without retypingEvery re-keyed charge is a chance for a wrong code or a missed service. | Treatments import from Aria and Mosaiq through Record & Verify; CodePath audits the treatment plan as the work is done. | Demographics and charges import once from OncoChart and CureMD. | Real-time eligibility fills the demographics and policy data from the payer's response. | The Connectivity Clearinghouse imports demographics and charges from major EMR and EHR systems. | Charges arrive from each client's EMR, and scanned EOBs, letters and authorizations attach to the account. |
| Patients who keep coming backRecurring care only pays if the next visit is booked and the follow-up happens. | The scheduler books machines, rooms, physicians and physicists, and the roster shows who is under treatment. | Eligibility is confirmed before each cycle, since coverage often changes mid-course on high-dollar drug claims. | Recalls by target month for surveillance cystoscopies, PSA checks and injection cycles, with each follow-up call logged. | Recurring appointments for dialysis and other long courses are booked as a series in one step. | Priority queues rank open claims so the day starts with the accounts worth the most, and to-dos are shown to each user at login. |
| Many practices, one teamA billing company has to keep each client's work, access and reporting separate. | Not usually an issue in radiation oncology | Not usually an issue in medical oncology | Not usually an issue in urology | Not usually an issue in nephrology | Access by practice site and per-user privileges, production and payer-mix reports per client, and Biller Productivity reports for the team. |
Every specialty also gets the shared core: real-time eligibility, the claim scrubber on every line, electronic claims through the built-in clearinghouse, automatic ERA posting and accounts receivable work lists. Why Iridium Suite.