Oncology Care

Automatically Manage Billing Requirements for the Oncology Care Model (OCM).

THE ISSUE:

The OCM program presents a significant additional—and time-consuming—administrative burden on your business office  

THE SOLUTION:

The RCxRules Oncology Care module makes it easy to manage the complex billing requirements of the OCM—automatically, and without hiring additional staff.

Chronology of OCM events

RCxRules Automation

Select eligible Beneficiaries (by Payer -Medicare Part A, Part B, Commercial Payers, etc.)

Yes

Exclude patients with End Stage Renal Disease (ESRD)

Yes

Identify the “Trigger” date Yes
Ensures E&M code is billed with Cancer DX Yes
Monitor 6-month period from “Trigger” date Yes
Bill Monthly Enhanced Oncology Services (MEOS) code G9678 for six consecutive months Yes
Exclude Care Management services that conflict with MEOS Yes
Check for Date of Death (Cease billing G9678 if so) Yes
Monitor consecutive bundles to ensure the MEOS code is not billed twice in one month Yes

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Protect your revenue and your future.

Your physicians and your staff are working harder than ever, and regulations continue to evolve. RCxRules is committed to leveraging our technology to help your organization thrive in this difficult environment. 

Our rules engine is constantly evolving to keep pace with the ever-changing requirements that will define healthcare for the next decade to come.

Let’s face these challenges together.

To learn more about what RCxRules can do for your organization, click here.