Oncology Care Model
Ensure accurate billing for efficient reimbursement
A program initiated by the Center for Medicare and Medicaid Innovation (CMMI), the Oncology Care Model (OCM) strives to improve quality and reduce cancer treatment costs for Medicare fee-for-service (OCM-FFS) and other plans (OCM-OP).
In addition to regular Medicare payments, practices receive a Monthly Enhanced Oncology Services or MEOS fee once a patient begins chemotherapy. Intended as a financial resource to aid in effectively managing and coordinating care for Medicare beneficiaries, the $160 MEOS fee may be billed monthly for up to six months, representing a potential $960 in revenue per patient episode.
The OCM features in g4 Studio automate what can be an error-prone manual process for OCM billing, freeing staff to focus on other high-value activities.
With Unlimited’s OCM tool kit, practices can:
Identify patients who qualify for an active OCM episode
Auto-generate a monthly claim with the appropriate HCPCS code (G9678) for correct billing
Highlight OCM patient appointments on the practice schedule
Automatically terminate the OCM episode when certain conditions are met
Protect your Medicare revenue, achieve bonus payments
As a significant payer for so many specialty healthcare claims, it’s important for specialty providers to maximize their Medicare reimbursements.
Effective MIPS reporting can mean the difference between increased Medicare Part B payments (with financial bonuses) and painful negative payment adjustments. By 2022, payment adjustments will range from a positive 9 percent with a 27 percent bonus potential, to a negative 9 percent. As the risk and reward increases every year, it’s more important than ever to protect your revenue.
That’s why Unlimited Systems offers a CMS-approved MIPS Qualified Registry (QR). Our MIPS Registry arms practices with easy-to-use tools for maximizing payment adjustments and avoiding financial penalties, while reducing staff burden.
With the Unlimited Systems MIPS Registry, you can:
Track progress with a custom dashboard and on-demand reports
Receive coaching from one of our value-based care experts