Oncology Medical Billing


Oncology Medical Billing Services

The fight against cancer demands unwavering care and precision. But behind the scenes, navigating the intricacies of Oncology Medical Billing Services can add undue stress. Juggling complex coding, insurance eligibility verification, and ever-changing regulations can seem overwhelming. ProMantra steps in as your trusted partner, offering comprehensive solutions to streamline your oncology billing and revenue cycle management, empowering you to focus on what matters most: your patients.


What is Oncology Medical Billing Services?

Oncology Billing Services refer to specialized billing and revenue cycle management solutions tailored specifically for oncology practices and healthcare providers. These services are designed to handle the complex billing processes associated with oncology, including but not limited to, claim submission, payment posting, denial management, insurance eligibility verification, prior authorization, oncology-specific coding, and compliance with coding guidelines.

Oncology Medical Billing Services aim to ensure accurate and timely reimbursement for the services provided by oncologists and oncology clinics. This includes billing for a wide range of oncology treatments and services, such as chemotherapy, radiation therapy, surgical procedures, imaging studies, laboratory tests, and consultations.

Services covered under Oncology Medical Billing Services:

It’s important to clarify that Oncology Billing Services don’t directly cover specific diseases. Instead, they focus on billing for the services rendered to patients diagnosed with various cancers and related conditions.

Oncology practices manage a wide range of cancerous and non-cancerous conditions under the umbrella of oncology. Here are some broad categories:

Primary Cancers:

  • Solid tumors: Breast cancer, lung cancer, colorectal cancer, prostate cancer, etc.
  • Hematological cancers: Leukemia, lymphoma, myeloma, etc.
  • Other cancers: Skin cancer, brain cancer, head and neck cancer, etc.

Pre-cancerous conditions:

  • Cervical dysplasia
  • Colon polyps
  • Atypical moles

Benign tumors:

  • Fibroids
  • Lipomas
  • Cysts

Paraneoplastic Syndromes:

  • These are rare conditions caused by the immune system’s response to cancer, such as Cushing’s syndrome or hypercalcemia.

Treatment-related complications:

  • Infections
  • Nausea and vomiting
  • Pain management

Supportive care:

  • Nutritional counseling
  • Psychological counseling
  • Palliative care


  • Physical therapy
  • Occupational therapy
  • Speech therapy

Medical Coding for Oncology Medical Billing Services:


Oncology care demands precision, not only in treatment but also in medical coding for oncology billing services. Navigating the intricacies of complex procedures, diverse diagnoses, and ever-evolving coding guidelines can be daunting. Worry not, this guide serves as your roadmap to accurate and compliant oncology coding:


Key Code Sets:

1. CPT (Current Procedural Terminology) codes: 

These define specific procedures performed, covering:

2. HCPCS Level II codes: 

These supplement CPT codes by capturing specific supplies and equipment used (e.g., A4553 for an allergy skin test).

3. ICD-10 codes: 

These diagnose patient conditions using alphanumeric codes, including various cancer types and related conditions (e.g., C50.9 for breast cancer, D04.7 for chronic lymphocytic leukemia).

Oncology Coding Specialties:


Oncology coders require proficiency in various subspecialties to accurately capture diverse services:


Medical oncology:

Coding chemotherapy, targeted therapies, and supportive care.


Surgical oncology:

Coding surgical procedures for cancer removal or reconstruction.


Radiation oncology:

Coding radiation therapy modalities and treatment plans.



Coding biopsy and other diagnostic test results.



Coding for blood cancers and related conditions.


Why Choose ProMantra for Oncology Billing?


Deep Expertise in Oncology:

We understand the unique challenges of oncology billing services, from intricate treatment plans to diverse diagnostic procedures and ever-evolving coding guidelines. Our certified coders and billing specialists possess in-depth knowledge of oncology coding, ensuring accurate and compliant claim submission.


Seamless Oncology Billing Solutions:

We leverage cutting-edge technology and automation to simplify your workflows. Our oncology billing and coding services encompass:

  • Outsource Oncology Billing Services: Offload time-consuming tasks like claim submission, eligibility verification, and payment posting to our dedicated team, allowing your staff to prioritize patient care.
  • Medical Coding Services: Ensure accurate CPT, HCPCS, and ICD-10 coding for complex oncology procedures and diagnoses, minimizing denials and maximizing reimbursements.
  • Oncology Revenue Cycle Management: ProMantra goes beyond claim submission. We offer comprehensive revenue cycle management solutions tailored to oncology practices, including:
    • Insurance eligibility verification services: Minimize claim denials with proactive verification for all patient insurance plans.
    • Prior Authorization services: Secure essential approvals efficiently to ensure prompt treatment for your patients.
    • Patient billing and collections: Manage patient billing effectively, minimizing bad debt and maximizing your practice’s revenue.
    • Detailed financial reporting and analysis: Gain valuable insights into your practice’s financial performance to make informed decisions.

Reliable Medical Billing Agency:

As a leading medical billing company, ProMantra adheres to the highest industry standards and ethical practices. We prioritize data security, HIPAA compliance, and transparent communication, giving you peace of mind.


Scalability and Flexibility:

Our billing company medical solutions are adaptable to your practice’s size and needs. We offer customized packages and seamless integration with your existing systems, ensuring a smooth transition and optimal fit.


Unburden Yourself with ProMantra’s Oncology Billing Services:


Outsource Oncology Billing Services:

Free up your staff’s time for direct patient care and prioritize practice efficiency by allowing our experts to handle your billing complexities.


Oncology Coding Services:

Ensure accurate CPT, HCPCS, and ICD-10 coding with our certified oncology coders, minimizing claim denials and maximizing reimbursements.


Medical Billing Service:

Leverage our automated processes and experienced team to streamline claim submission, payment posting, and follow-up.


Insurance Billing Companies:

We handle communication with various insurance billing companies and navigate complex regulations, ensuring smooth claim processing and timely reimbursements.


Prior Authorization Services:

Our team simplifies the prior authorization process by obtaining approvals efficiently, minimizing treatment delays and ensuring prompt care for your patients.


Beyond Billing: A Holistic Approach to Your Oncology Practice’s Success:


ProMantra offers more than just insurance billing services. We are your comprehensive partner in practice optimization:


Practice Management Consulting:

Our experienced consultants provide valuable insights and data-driven recommendations to improve operational efficiency and financial performance.


Marketing and Patient Engagement Solutions:

Attract new patients and strengthen patient relationships with our targeted marketing and engagement strategies.


Technology Solutions:

Leverage our cutting-edge technology platform to streamline workflows, improve communication, and gain valuable data insights.


Partner with ProMantra and Unlock the Full Potential of Your Oncology Practice:


By choosing ProMantra as your Oncology Medical Billing Services provider, you gain:


Increased Revenue and Reduced Costs:

We ensure accurate coding, timely claim submission, and minimized denials, maximizing your reimbursements and reducing administrative costs.


Improved Efficiency and Productivity:

Our automated solutions and expert team free up your staff’s time and resources, allowing them to focus on patient care.


Enhanced Patient Experience:

Streamlined billing processes and efficient communication contribute to a positive patient experience, fostering loyalty and trust.


Peace of Mind and Compliance:

Our HIPAA-compliant practices and dedicated support team ensure you can focus on providing exceptional care with confidence.

Ready to simplify your oncology billing and prioritize patient care? Contact ProMantra today for a free consultation and discover how our comprehensive solutions can propel your practice to new heights.

Let’s Talk

To learn more about our Oncology medical billing services or to request a quote, please contact us today. We will be happy to assist you.