Specialties

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.

How Iridium Suite handles the billing problems that differ by specialty
Billing problemRadiation 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 nephrologyNot 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 oncologyNot usually an issue in medical oncologyNot usually an issue in urologyNot 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.