By Aaron Brammer
This blog post is modified from an article that appeared in Radiation Oncology News for Administrators Vol 33 No 2.
In 2023, SROA and the American Society for Radiation Oncology (ASTRO) have teamed up to tackle payor challenges. Both societies are collecting examples of inappropriate denials and delays in care and identifying trends and themes. We will be meeting with the payors to present patient cases and scenarios of commonly experienced, inappropriate prior-authorization trends.
By Tammy McCausland
This blog post is modified from an article that appeared in Radiation Oncology News for Administrators Vol 32 No 5.
Denial are complex, time consuming, costly to rectify and increasing yearly.
Payers complicate the billing process by creating their own rules. And now they’re using artificial intelligence (AI) tools to deny more claims.1
SROA members began Day 2 of SROA’s 2022 Annual Meeting with a general session called, “Centering Diversity in Radiation Oncology: The What, The Why, and The How.” Dr. Parul Berry, Dr. Jerry Jaboin and Dr. Ivy Franco provided historical context about diversity and shared some of the personal challenges they have encountered as radiation oncologists from underrepresented minority groups. They offered numerous concrete suggestions on how radiation oncology departments and centers can diversify their radiation oncologist staff and improve their retention. Some suggestions include: giving less weight to test scores; exploring more deeply the reasons for lower test scores (for example, due to lack of financial resources to take test prep courses); and having standardized questions for all interviewees. The panelists also talked about ways to improve retention such as ensuring that the HR partners have the appropriate expertise for specific circumstances.
This article is adapted, in part, from an article that appeared in SROA’s publication, Radiation Oncology for Administrators (Vol 31 No 5).
The National Cancer Institute describes financial toxicity as “problems a cancer patient has related to the cost of treatment.” Out-of-pocket costs, such as copayments, deductibles and coinsurance not covered by health insurance, can cause patients financial distress. Financial hardship due to treatment can cause higher household debt, depletion of savings and even the need to seek bankruptcy protection. Financial issues affect patients’ emotional and physical well-being and their survival. Some patients may even have to delay or abandon treatment.
Teri Bedard, Executive Director, Client & Corporate Resources with Revenue Cycle Coding Strategies, discusses the RO-APM. This content originally appeared in Radiation Oncology News for Administrators, Vol. 31 No. 3.
Teri Bedard, Executive Director, Client & Corporate Resources with Revenue Cycle Coding Strategies, discusses some common billing and coding issues. This content originally appeared in Radiation Oncology News for Administrators, Vol. 31 No. 3.
Susan Vannoni, founder and CEO of Radiation Oncology Consulting LLC (ROC), provides some helpful answers in this Q&A to common questions about treatment delivery and management of stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). All codes listed in this Q&A are from the AMA CPT.
As my organization shifts to discussions about participation in the radiation oncology alternative payment model (RO-APM), I am worried about the costs of meeting this new mandate. If our country is serious about a value-based payment system for health care, we must make sure that the total cost of delivering and demonstrating value is part of the equation.