AI-Powered RCM Built for Oncology Practices
From chemotherapy drug J-codes and buy-and-bill to administration coding and regimen-level authorization — SCALE delivers revenue cycle intelligence purpose-built for oncology groups, infusion centers, and MSOs.
Drug & J-Code Billing
Chemo/biologics, buy-and-bill, wastage (JW/JZ)
Infusion & Administration Coding
Hierarchy, hydration & sequencing rules
Prior Authorization
Regimen-level auth & pathway compliance
Specialty Pharmacy Coordination
White/clear-bagging & payer mandates
Real-Time RCM Analytics
Live dashboards via SCALE's analytics platform
Oncology billing is uniquely complex. We know it cold.
High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
Drug Margin & J-Code Exposure
High-cost chemo and biologic buy-and-bill, wastage (JW/JZ), and unit accuracy put six-figure revenue at risk per error.
Infusion-Hierarchy Coding
Initial/sequential/concurrent administration rules and hydration sequencing carry strict documentation requirements.
Regimen-Level Authorization
Payers increasingly require pathway compliance and regimen-level prior authorization that delay treatment and revenue.
How SCALE solves it
Oncology Prior Authorization
We manage regimen-level authorization and pathway compliance end to end — including appeals.
Oncology Coding & Charge Capture
Automated review flags J-code unit, wastage, and administration-hierarchy errors.
Oncology Denial Management
Payer-specific appeal templates for drug, medical-necessity, and pathway denials.
Drug & Infusion Revenue Integrity
Accurate buy-and-bill, JW/JZ wastage, and administration capture protect high-cost revenue.
End-to-end RCM for every Oncology encounter
Automation handles volume and velocity. Our experts handle exceptions, edge cases, and strategic optimization — creating a closed-loop system that continuously improves performance over time.
Discovery & Audit
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
EHR Integration
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
Go-Live & Handoff
SCALE's dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Continuous Optimization
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE clients
Representative results across SCALE Healthcare clients. Individual outcomes vary by organization size, payer mix, and baseline RCM maturity.
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
Works inside the EHRs your team already uses
Let’s build your Oncology RCM roadmap together
Book a free 30-minute strategy call with a SCALE Oncology specialist. We’ll review your current denial rates, authorization backlog, and coding performance — at no cost.