Technology Solutions Addressing Coding Burdens in Rad Onc

In an article published earlier this month, a MedCity News influencer explored how an AI technology is bringing relief to coding challenges for physician providers. At Fuse Oncology, we are well versed in the radiation oncology industry’s complex coding demands due to various new and changing treatment modalities, bodily target specifics, and dosing calculations requiring advanced documentation. 

Radiation oncology providers attempt various methods to manage complex coding demands; still, most are affected by incorrect and missing charges and revenue cycles fraught with inefficiencies. No provider can thrive with large sums of money at risk annually.  

Numbers help tell the story. Healthcare providers spend $82.7B annually on documentation, coding, and other administrative tasks. A 2024 survey found that providers spent nearly $20 billion pursuing delays and denials across payer types, and just over half of that comes from denied claims that are eventually paid out—about $10.6B is “wasted arguing over claims that should have been paid at the time of submission.”  

That’s why Fuse’s S!GNAL technology was created using AI to proactively catch problems before they occur. A solution that uses automation and data from electronic medical records (EMRs)—along with provider-specific configuration rules—verifies that services are being captured and/or documented directly. Let’s take a look at why this matters. 

Physician, staff value 

As healthcare staffing shortages across various specialties—including radiation oncology—persist, today’s burden of coding is substantial. It’s becoming more complex and heavier, with administrative responsibilities exploding in tandem with demand for provision of services. Certified medical coders are also experiencing shortages—30% nationwide. Technologists and physicians are left to fill the gap, spending significant time away from patients and not practicing at the top of their licenses.   

These administrative responsibilities have contributed to the burnout epidemic in medicine. With demands for patient care high, many physicians are dealing with billing responsibilities during evening and nighttime hours instead of pursuing hobbies or enjoying personal or family time. 

While physicians try their best, most are simply not well versed in the ever-changing  complexities and nuances of medical coding. As the MedCity article points out, there are over 69,000 ICD-10 diagnosis codes and over 10,000 procedure codes, straining all manual processes that are impacted by frequent guideline changes. Accuracy has become a huge problem. Coding errors on the front end are later denied, or delayed, and demand time-intensive rectification. It’s an endless cycle. 

The pairing of AI with human expertise 

The article explores how leveraging AI “finally frees physicians from one administrative burden that pulls them away from patient care,” with “compelling and reassuring” evidence that AI technology maintains or exceeds compliance standards while reducing operational costs and complexity. We at Fuse agree. But we also have vast experience in medical coding and understand that the nuance, intricacies, and changing landscape of rad onc coding limit technology automation’s impact. Technology application in the revenue cycle still requires human intervention. 

When we work with our customers, we help them write rules—or policies—that state explicitly the expectations from a code capture and documentation perspective. We use our payer expertise to ask the right questions about patients and workflows, and clarify their policies to ensure the software is aligned with their needs. We have very human conversations with customers about charges and documentation to understand their expectations and redirect all coding staff members, as needed, to consistently meet those expectations.  

It takes more than technology to fully automate coding for radiation oncology clinics seeking accuracy, consistency, and scale. It requires human understanding. This asset can elevate operations beyond billing and coding to improve the operations of an entire radiation oncology department through integration of business and clinical intelligence capabilities for better patient care. Reach out to learn more about how Fuse Oncology can help.