The OCM program presents a significant additional—and time-consuming—administrative burden on your business office
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||
|Select eligible Beneficiaries (by Payer -Medicare Part A, Part B, Commercial Payers, etc.)||
|Exclude patients with End Stage Renal Disease (ESRD)||
|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|
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.
“RCxRules has dramatically improved our first pass clean claim rate. We have put a great deal of effort into establishing sound business office policies and payer rules – now those rules live in the technology and are integrated into our staff’s workflow. Since the RCxRules solution reviews every charge, it ensures full compliance with all of our policies. We have confidence that these improvements are sustainable with future opportunities for even more improvement”
Robert Wood Johnson Physician Enterprise, P.A.