Oncology revenue cycle management

Oncology revenue is high-dollar and authorization-heavy - chemotherapy J-codes, NDC units, drug wastage and prior auth. AI agents capture every unit and clear every auth before treatment.

Oncology carries some of the highest-dollar, most complex claims in medicine: chemotherapy and biologic J-codes billed by NDC units, JW drug-wastage capture, infusion time coding, and heavy prior authorization. A single missed unit or auth is expensive. MedXFlow supports drug and infusion coding, secures authorizations, and protects every dollar through posting and denials.

Drug & infusion billing

• J-code & NDC unit billing - Bills chemotherapy and biologic J-codes with correct NDC units so nothing is under-billed.
• Drug wastage (JW) capture - Captures discarded drug with the JW modifier so wastage is reimbursed.
• Infusion time coding - Codes infusion and hydration time correctly, including sequential and concurrent rules.

Prior authorization

• Regimen authorization - Submits chemotherapy and specialty-drug authorizations with clinical documentation.
• Auth-to-treatment matching - Confirms the authorization matches the regimen before treatment and tracks it to approval.

Eligibility & benefits

• Specialty-drug benefit checks - Verifies medical and pharmacy benefit coverage for high-cost therapy.

Claims, posting & denials

• Underpayment detection - Flags underpayments against contracted rates on high-dollar claims.
• Denial management - Works authorization and unit denials fast, given the dollar stakes.

What you get

• Every drug unit and wastage captured
• Authorizations matched to the regimen
• Underpayments detected on high-dollar claims
• Fewer costly authorization denials