Drug unit errors
J-code claims denied or underpaid for unit miscalculation. We convert dosages to billing units per code.
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Hematology medical billing services
Hematology bills complex E/M, infusions and injections, and expensive drugs, often alongside oncology. The revenue risk is in drug billing: J-codes, units, wastage, prior authorization and the buy-and-bill economics that decide whether an infusion makes money or loses it.
What makes hematology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether hematology claims pay the first time.
- Infusion and injection administration (96360–96379) follow hierarchy and time rules, with initial, sequential and concurrent codes.
- Drug J-codes must be billed in the right units with wastage documented and modifier JW or JZ applied as payers require.
- Prior authorization is required for most high-cost agents, including iron infusions and biologics.
- Anticoagulation management and transfusion-related services have their own code sets and frequency rules.
Denials we see most in hematology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Wastage modifiers
Claims denied for missing JW or JZ. Applied per payer rule at the scrubber.
Infusion hierarchy errors
Administration codes denied for wrong initial and sequential logic. We apply the hierarchy from the infusion record.
How Core MB bills for hematology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new hematology providers runs in the same system, tracked live in your client portal.
- Drug and administration billing verified from the infusion record.
- Prior authorization management for high-cost agents.
- Buy-and-bill margin reporting so you know which drugs pay.
Everything in the service
The full revenue cycle as standard for hematology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Hematology billing questions
What is the most common hematology billing error?
Drug units. A J-code's billing unit rarely matches the clinical dose, and miscalculation underpays or denies the claim. We convert every dose.
Do you handle wastage billing?
Yes. We document wastage and apply JW or JZ as each payer requires.
Can you report on infusion profitability?
Yes. We report reimbursement against drug cost by agent so you can see which infusions are worth providing in-office.
How do we get started with Core MB for hematology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new hematology providers can start at the same time.
Find out what your hematology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.