Hematology Medical Billing & Credentialing Services

Accurate Coding. Seamless Credentialing. Faster Payments.

Expertise in Hematology Revenue Cycle Management

Hematology billing is one of the most specialized and compliance-heavy areas in healthcare. From complex lab testing and infusion therapy codes to cancer screenings, chemotherapy administration, and coordination of care for chronic blood disorders — precision is everything.

At Oakview Medical Billing Solutions, we deliver specialized revenue cycle management services for hematologists, oncology-hematology practices, transfusion clinics, and hospital-based providers. We ensure every claim reflects accurate codes, compliant documentation, and payer-specific billing rules.

Whether you treat anemia, leukemia, lymphoma, hemophilia, or other blood-related disorders, we eliminate reimbursement errors so you can focus on your patients.

Billing Challenges Faced by Hematology Practices

Infusion & Chemotherapy Coding
Accurate use of J-codes and administration codes is essential. Billing multiple drugs and hydration services requires careful sequencing and modifier use.

Bundled vs Unbundled Services
Laboratory services may be bundled under global codes—incorrect billing often leads to denials or audits.

High Audit Risk
Due to expensive drug costs (e.g., Rituximab, Darbepoetin), payers frequently audit claims for correct units and medical necessity.

Prior Authorization Complexity
Payers often require PA for high-cost biologics or therapeutic infusions. Missing this step delays reimbursement significantly.

Place of Service & NCCI Edits
Billing must match POS codes (11, 22, 24, etc.) and adhere to NCCI edit rules to avoid rejections on bundled services.

Who We Serve

• Independent Hematologists & Group Practices

• Hematology-Oncology Centers

• Hospital-Based Hematology Departments

• Pediatric Hematology Clinics

• Transfusion Clinics & Blood Banks

CPT Code Table (Core Hematology Services)

Hematology Credentialing Services

Oakview handles all aspects of hematology credentialing and payer contracting:

• Medicare, Medicaid, BCBS, UHC, Cigna, Aetna, Humana, Molina

• J-code enrollment with appropriate fee schedules

• Oncology/hematology specialty designation (PECOS, CAQH updates)

• Credentialing for infusion therapy centers

• License/DEA verifications, NPI registration, and payer-specific documentation

We track every submission and follow up until you're fully in-network and actively reimbursed.

Why Hematologists Trust Oakview

• Oncology-Hematology Coding Expertise – Certified coders trained in complex CPT/HCPCS, chemo infusion, and blood transfusion rules.

• Pre-Authorization Management – We manage prior auths for biologics, injections, and diagnostics.

• Denial Prevention & Appeals – Real-time scrubbing, modifier checks, and aggressive follow-up on underpayments.

• Custom Reporting – Claim aging, net collection rate, and drug-specific reimbursement tracking.

• Dedicated Account Manager – Your personal billing expert for day-to-day RCM questions and updates.

Our Hematology RCM Solutions Include:

✔ Accurate HCPCS (J-code) billing for biologics & injectables
✔ Modifier usage (e.g., 59, 25, JW, JZ) for compliant billing
✔ Prior authorization tracking + status updates
✔ Compliance audits for high-dollar claims
✔ Insurance verification within 24 hours
✔ Credentialing and revalidation tracking
✔ Payment posting with variance analysis

Let Oakview Take Over Your Hematology Billing

We understand the depth and complexity of hematology billing, credentialing, and compliance. That’s why hematologists across the U.S. rely on Oakview Medical Billing Solutions to improve cash flow, reduce denials, and simplify their operations.

Let’s talk today. One call can transform your entire billing process.