AI-Powered Oncology Billing Services in California | 99.9% Clean Claim Rate
Transcure’s expert, compliant, and optimized Oncology billing services for California practices:
- Ensure correct chemotherapy and radiation therapy CPT/HCPCS coding with 2026 updates.
- Navigate complex prior-authorization rules for biologics, immunotherapy, and high-cost oncology drugs.
- Comply with California payer and Medicare requirements to avoid audits or denials.
- Bundle infusion services, drug administration, supplies, and facility fees correctly for full reimbursement.
- Accelerate claim submission and Oncology RCM to increase revenue by 20%.
What Oncology Billing Challenges Do California Practices Commonly Face?
California oncology practices often struggle with several billing pitfalls that threaten revenue flow and compliance:
- Complex Coding & Modifier Errors: Oncology uses specialized CPT/HCPCS codes along with modifiers, like JW for drug waste, -59 for distinct services, and small mistakes can trigger denials.
- Prior-Authorization Failures: Many chemotherapy, immunotherapy, or high-cost drug claims get denied or delayed when prior authorizations are incomplete or not obtained.
- High Denial Rate: Cancer practices see denials often due to incorrect HCPCS drug codes or misaligned ICD-10 staging, especially with biologics and complex regimens.
- Regulatory and Policy Changes: Coding updates, drug reimbursement guidelines, and payer-specific rules change often, making it difficult for in-house billing teams to stay current.
How Transcure Helps CA Practices With Their Oncology Billing Services?
Transcure’s Oncology billing and coding services in California help practices overcome every RCM challenge. We offer the following services to CA oncology practices:
Patient Access & Benefits Verification
Transcure verifies insurance eligibility and benefits before oncology treatment, preventing unexpected denials.
Prior Authorizations & Pre-certification
We secure timely authorizations for chemotherapy, immunotherapy, radiation, and high-cost oncology drugs under California payer rules.
Accurate Oncology Coding & Charge Capture
Our 1100+ AAPC-certified coders handle complex CPT/HCPCS, ICD-10 cancer-staging, infusion, and drug-unit coding to avoid underbilling.
Clean Claim Submission & Denial Management
We scrub claims, submit correctly, monitor rejections, and manage rapid appeals to recover lost revenue.
Patient Billing & Financial Assistance Handling
We manage buy-and-bill separation, 340B compliance, and transparent patient-billing statements for oncology services.
A/R Recovery, Reporting & Revenue Analytics
We provide A/R follow-up, KPI dashboards, reconciliation, and regular revenue-cycle reports to keep your oncology practice financially healthy.
Our Success in Numbers
Which Cities Does Transcure Serve with Their CA Oncology Billing Services?
Los Angeles, California
San Diego, California
San Jose, California
View All Cities
San Fransisco, California
Fresno, California
Sacramento, California
Long Beach, California
Bakersfield, California
Oakland, California
How Transcure’s AI-Powered Oncology Billing RCM Ensures a 99.9% Clean Claim Rate?
Transcure has integrated 7 AI agents into our California oncology billing and RCM services:
- ELIXA instantly verifies patient insurance eligibility using real‑time AI insights.
- PRIA automates prior authorization by detecting cases and following up with payers.
- CODIN reads clinical documentation and assigns precise CPT and ICD-10 codes.
- CLAIR scrubs and builds claims intelligently, detecting errors before submission.
- DEXA analyzes denial trends, drafts appeal letters, and calls payers to recover revenue.
- ARIS tracks unpaid claims, prioritizes them, and engages payers using predictive AI.
- REMITA reconciles payments automatically by matching ERA and EOB data.
Which Counties Benefit from the Transcure Oncology Billing Services in California?
Los Angeles County
San Diego County
Orange County
Riverside County
San Bernardino County
Santa Clara County
What Different Oncology Procedures Does Transcure Handle with Their California Billing Services?
We support billing for a broad range of oncology procedures in California. Here are six key ones:
Chemotherapy Infusions
Transncure supports coding and billing for IV chemo, oral oncology drugs, infusion time, drug-units, and supporting admixtures per payer guidelines.
Radiation Therapy
We handle coding for simulation, treatment planning, delivery, and follow-up treatments under CPT/HCPCS for radiation oncology.
Immunotherapy & Targeted Biologic Treatments
Our billers bill monoclonal-antibody therapies, checkpoint inhibitors, targeted biologics, and related administration codes accurately.
Surgical Oncology & Biopsy Procedures
Transcure manages billing for tumor excision, biopsy, lymph node dissection, and reconstructive or debulking surgeries.
Diagnostic Imaging & Nuclear Medicine
Our coders code cancer-staging scans, like PET, CT, and MRI, and follow-up imaging studies critical for diagnosis, monitoring, and treatment planning.
Pathology, Genetic Testing & Lab Services
We bill pathology, tumor-typing, biopsy analysis, immunohistochemistry, or genetic/genomic tests needed for diagnosis and treatment decisions.
Why Should You Outsource Oncology Billing Services in California to Transcure?
You should outsource Oncology billing services to Transcure, as we provide:
Certified Oncology Coders
Expert CPT/ICD-10/HCPCS coding by AAPC-certified coders reduces denials from drug, infusion, and cancer-treatment claims.
End-to-End RCM Coverage
From patient intake, eligibility checks, claim submission, to payment posting and AR follow-up, we have your entire billing lifecycle covered.
AI-Powered Automation & Error Reduction
Automation tools streamline claim scrubbing and submission, cutting errors and accelerating reimbursements.
Denial Management & Rapid Appeals
We monitor rejections, handle appeals, and recover revenue that might otherwise be lost.
Transparent Reporting & Financial Insights
Real-time dashboards and reports give clear visibility into collections, denials, AR days, and revenue performance.
Complimentary Credentialing for New Oncology Practices in California
Starting a new oncology practice? With Transcure, you get free credentialing and payer enrollment. It is a full setup service that verifies licenses, submits CAQH and insurance applications, and ensures you’re ready to bill. Avoid months of delays before your first reimbursement.
Our credentialing team handles all payer communication, application follow-ups, and network enrollments, so you start seeing payments ASAP. Let us manage the paperwork while your oncology team focuses on patient care and growth.
Which Oncology Billing EHRs Does Transcure Support?
Our team at Transcure works comfortably with more than 32 EHR/EMR programs for Oncology billing services, including:
How Oncology Practices Benefit from Our Medical Billing Services?
Read our partners’ success stories to recognize the worth of our Oncology RCM services for financial growth.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions (FAQs)
What coding challenges arise in oncology billing?
Oncology requires precise CPT/ICD-10 codes for infusions (e.g., 96413), radiation sessions, and drug administration, with modifiers for bundles to avoid denials from undercoding or unbundling.
How does Medi-Cal billing work for oncology in California?
Providers enroll via DHCS online application with NPI, licenses, and taxonomy codes, verifying eligibility for chemotherapy/radiation claims while meeting state-specific prior auth and documentation rules.
What causes common denials in oncology claims?
Denials often result from missing prior authorizations, incomplete infusion documentation, NCCI edits, or payer-specific bundling rules, leading to 20-30% rejection rates without expert scrubbing.
What metrics define a top oncology billing partner?
A 95%+ clean claims rate, 20%+ revenue gains, Medi-Cal expertise, a denial rate <10%, certified staff, and dashboards make for a dependable billing partner. Transcure excels in all of these things with top-of-the-industry statistics.
What compliance is required for California oncology billing?
HIPAA-secure systems, CMS/Medi-Cal audits, annual coder training (CPEDC certs), and real-time updates prevent penalties from evolving rules on high-risk drug billing.