Determine if Insurance is current and active, deductible & OOP
Determine what services are covered under patient's policy
Determine oncology specific co-pays/co-insurance (incl. Chemo, Rad Tx, Lab, Radiology, etc.)
Determine if oncology services meet medical necessity (incl. Chemo, Rad Tx, Lab, Radiology, etc.)
Determine Pharmacy Benefits/DME (Oral Oncolytics)
Pre-Authorization for all oncology services
Check unique payor restrictions for oncology services
Determine if PCP referral is required/ACO Designation /Rules
Hourly Pay Rate $15.00
Taxes and Benefits Costs$3.56
Total Cost per Hour$18.56
Yearly Costs$38,613.12
Average cost of sick days,
holiday pay, vacation and overtime $2,970.24
Average training, continuing education,
office supplies and miscellaneous costs$6,237.50
Our research shows that it takes 1 Full Time Equivalent (FTE) per 4 providers to
properly staff your office to accurately complete the Comprehensive Benefit Investigations
and to handle the ever increasing amount of Treatment Plan Authorizations.
1 FTE per 4 Providers ($47,820.86 / 4 = $11,955.21)
In-House Cost per Provider = $11,955.21