Encyclopedia of Radiation Oncology

2013 Edition
| Editors: Luther W. Brady, Theodore E. Yaeger

Understanding Radiation Oncology Billing, Collections, and Insurance Issues

Reference work entry
DOI: https://doi.org/10.1007/978-3-540-85516-3_156

Understanding Medicare

For patients who have Medicare Part B as their primary insurance (these are the majority of radiation oncology patients), Medicare has a predetermined fee which is paid for each medical procedure, billed as a current procedural technology (CPT) code. Medicare pays 80% of this allowable, and the patient’s secondary insurance pays the remaining 20%. Charges are electronically billed, turnaround time to receive payment can be as few as 14 days. Some secondary insurances will take between 6 and 9 months to pay the final 20%. Many secondary insurances must be billed using a paper claim sent through the mail instead of an electronic claim, thus delaying payment for up to 6 months (Schilling 2007a). Medicare Part B provides outpatient services for patients in a bundled fashion – professional and technical components of radiation treatment are paid in one lump sum.

Hospital-owned, hospital-based radiation oncology practices bill under Medicare Part A. This provides for a...

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References

  1. CMS (2010a) Centers for medicare and medicaid services web site: sustainable growth rate 2010. www.hhs.gov.med
  2. CMS (2010b) Centers for medicare and medicaid services web site: medical economic index 2010. www.hhs.gov.med
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  6. Schilling PJ (2007a) Economics of radiation oncology, chapter 98. In: Halperin EC, Perez CA, Brady LW(eds) Perez and Brady’s principles and practice of radiation oncology, 5th edn. Philadelphia, Lippincott Williams & Wilkins, pp. 2043–2049Google Scholar
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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Community Cancer Center of North FloridaGainesvilleUSA