Understanding Billing and Coding in Radiation Oncology Practice

In the newest episode of RadOnc on the Run, host Brandon Mancini, MD, MBA, FACRO, spoke with Ron DiGiaimo, MBA, FACHE, about strategies for handling billing, coding, reimbursement, and other financial tasks seen in radiation oncology practice. DiGiaimo offered his advice on critical changes to certain financial and payment processes that practicing radiation oncologists should be aware of.

The discussion touched upon concerns surrounding payment rates for Medicaid and Medicare, especially in rural areas. Although he noted that radiation oncology is “doing well,” DiGiaimo expressed his concern that some institutions may lose money or even close due to financial strain. He recommended that physicians negotiate a percentage of a specific year’s rates to help insulate themselves from future cuts.

Mancini and DiGiaimo also emphasized greater training and advocacy for radiation oncologists when it comes to understanding billing and revenue cycles, especially early on in a physician’s career. DiGiaimo specifically highlighted the potential benefits wealth managers can provide to radiation oncologists and detailed the importance of engaging in the proposed and final rules by Centers for Medicare & Medicaid Services (CMS).

Other topics of conversation included the necessity of creating protocols for different disease diagnoses and appealing denials to avoid future appeals and sustain good reputations among insurance companies. Mancini and DiGiaimo also explored how artificial intelligence (AI) may play a greater role in this space, as AI-based tools may assist with timely adjustments to insurance algorithms while reducing paperwork among clinicians.

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY^®. DiGiaimo is chairman of Revenue Cycle Coding Strategies (RCCS)/Regents Health Resources/RC Billing, which aims to help doctors and hospitals with coding for outpatient specialties.