Infusion Centers

Streamlining Your Infusion Center Revenue Cycle
- For Optimal Performance

Mastering Infusion Center Billing with Best Practices

In the increasingly complex realm of healthcare, managing the revenue cycle in infusion centers is essential. The intricate billing requirements, continuously evolving regulations and guidelines, the necessity of accurate clinical documentation, and revenue leakage pose challenges in efficiently executing the revenue cycle operations, resulting in delayed reimbursements and decreased cash flow. We understand these challenges and how they can impact your overall revenue. This is where our knowledge and expertise in coding and billing of Infusion, Injection and Hydration therapies become indispensable to ensure precision in your billing processes.

At RCM Workshop, our billers and coders are very knowledgeable on Infusion hierarchy and coding guidelines to maximize revenue while complying with regulatory requirements. We take a meticulous approach to managing every aspect of your infusion center billing services to maximize reimbursement and maintain the financial stability of your practice. Our tailored solutions can streamline your billing processes and optimize your revenue streams.

Unbeatable Service, Quality & Price

ACCURACY
0 %
TURNAROUND TIME
< 0 Hours
COLLECTION
0 %
PRICE
Starting from $ 1100 /Month

Challenges

Challenges in Infusion Center Medical Billing

Adherence to payer-specific rules and guidelines: Each insurer may have different requirements for billing infusion services, such as pre-authorization for high-cost medications or specific documentation for particular treatments. Navigating them can be difficult and time-consuming, causing reimbursement delays or denials if not handled correctly.

High cost of specialty drugs: Expensive drugs used in infusion treatments also presents a billing challenge. They are expensive, and even small billing errors can cause major financial losses. Infusion centers must ensure proper billing and reimbursement to cover the costs, but underpayments and denials are common when dealing with high-cost drugs.

Coordination between clinical staff and billing departments: Infusion therapy involves multiple clinical touchpoints, from physicians to nurses, and a breakdown in communication between clinical documentation and billing can lead to errors. The billing team must often work closely with clinical staff to ensure accurate charge capture. 

OUR PROCESS

Our Infusion Center Billing Workflow

We at RCM Workshop have corresponded with experienced and knowledgeable professionals who are well-versed in the intricacies of infusion center billing services. Our expert coders and billers follow the latest guidelines, ensuring accuracy in documentation and claim submission. Our rigorous review and audit address inefficiencies quickly and provide solutions that minimize errors and reduce claim rejection rates, resulting in a swift turnaround and higher revenues for your practice.
Our solutions are tailored to fit the specific needs of your infusion center, be it chemotherapy, immunotherapy, blood transfusions, hormone therapy, or any other specialized treatments. Our bespoke billing solutions align with the operational and financial needs of your centers. In the healthcare landscape where compliance is paramount, we ensure every claim adheres to payer requirements and HIPAA guidelines, resulting in enhanced clean claim submission. We believe in maintaining transparency in all our operations, giving you full control over your billing process.

Order Intake

Capture and collect necessary patient information, including patient demographics, insurance details, diagnosis codes and medical history.

Eligibility & Benefits Verification

Confirm patients’ primary and secondary insurance and verify their benefits coverage, co-pays, co-insurance, and deductibles.

Prior Authorization

Initiate request for prior authorization with the payers for the infusion services, follow-up to check auth status till closure and finally update the system with Auth approval reference number.

Medical Coding

Check accuracy of codes and modifier according to specialty and assign corresponding and appropriate charges to the codes.

Charge Posting

Enter the charges for the services provided into the billing system including the cost of the medication and the administration fee.

Claims Edits & Submission

Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.

Payment Posting

Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.

Denial Management

Analyse and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.

AR Management

Follow-up with payers to gather status for unpaid claims, and their resolution.

Patient Collection

Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.

BENEFITS

Outcomes guaranteed

With years of experience in Infusion Center billing services, we bring unparalleled industry knowledge that translates into faster reimbursement and increased cash flow. Our analytics driven approach and meticulous review help us to address inefficiencies quickly, resulting in minimized denials and maximized revenue.

Efficient insurance verification

>99% clean claim submission

Efficient authorization management

<24 hours turn-around time

Efficient coding & code review

>25% increased reimbursement

Efficient denial management

<5% claims denials

Proactive accounts receivable follow-up

<40 days AR & reduced aging

Better coordination & process optimization

improved patient satisfaction

WHY US?

Why partner with us

The infusion centers are subject to intricate billing, often involving high-cost medications, multi-payer systems, and evolving regulations and guidelines. Traditional billing approaches often fall short of addressing these challenges, leading to denied claims. With RCM Workshop, you can rest assured that your revenue cycle operations are in good hands. We are committed to delivering unparalleled support that not only gives you revenue protection but also ensures sustainability and growth in the extremely competitive healthcare landscape. Partner with us today to transform your billing operations.

Guaranteed Improvement in Reimbursement and
Cash Flow

Reduction in Denials
and AR

Transparent reporting
– NO BLACK BOX

100% data security
& HIPAA compliance

On demand scale up
of operation

Significant Reduction
in Cost > 75% Savings

Simple & No
Cost transition

Flexible & Unbeatable
Pricing Plan