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AI-Powered Revenue Optimization

AI-Enabled Hematology Billing That Accelerates Payments and Reduces Errors

Optimize your revenue cycle with AI-Enabled hematology medical billing designed to handle the complexity of hematology treatments, oncology-related services, and infusion therapies. Our intelligent automation improves coding accuracy, identifies errors before submission, and speeds up claim processing to reduce denials and payment delays. With real-time insights, proactive denial management, and compliance-focused workflows, we help hematology practices increase collections, stabilize cash flow, and eliminate administrative bottlenecks—so your team can focus on patient care instead of paperwork.

  • Trusted by hospitals, hematology specialist and hematology groups nationwide
  • HIPAA-compliant + Fully U.S.-based billing oversight
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Our Services

Why Hematology Medical Billing Requires Specialized Expertise

Smarter hematology billing that improves cash flow and minimizes administrative burden.

High-Cost Drug & Infusion Billing

Hematology treatments often involve expensive biologics, chemotherapy agents, and infusion therapies. Incorrect drug coding, units, or wastage reporting (JW/JZ modifiers) can lead to significant revenue loss or claim denials.

Prior Authorization Requirements

Many hematology treatments, specialty drugs, and infusion services require prior authorization. Missing or incomplete approvals can result in delayed payments or fully denied claims.

Complex CPT, HCPCS & Drug Coding

Hematology services require precise coding for infusions, injections, lab tests, and drug administration. Errors in CPT, HCPCS (J-codes), or diagnosis linkage can trigger rejections or underpayments.

Strict Medical Necessity Documentation

Payers require detailed clinical documentation to justify high-cost therapies and ongoing treatments. Insufficient treatment plans, lab results, or progress notes often result in audits or denials.

Payer-Specific Coverage Variability

Coverage for hematology drugs, infusion frequency, and treatment protocols varies widely by payer and policy. Failure to follow payer-specific rules increases compliance risks and administrative rework.

Denial Management & Revenue Leakage Risks

Hematology claims face high scrutiny due to treatment costs and complexity. Without proactive denial tracking and correction, practices may experience delayed reimbursements and significant revenue leakage.

Due to the complexity of hematology services, many practices partner with specialized billing experts to improve revenue performance and streamline operations.

Our Services

AI-Powered Hematology Medical Billing for Faster Revenue

Improve accuracy, reduce denials, and accelerate reimbursements.

Accurate Hematology Coding & Charge Capture

We ensure precise coding for hematology visits, diagnostic services, infusion therapies, and complex treatment protocols to maximize clean claims, reduce denials, and improve reimbursement accuracy.

Specialty Drug & Infusion Billing Management

Our team accurately handles high-cost medications, J-codes, dosage units, drug wastage (JW modifier), and administration services to prevent underpayments and ensure full reimbursement.

Claims Submission & Payment Follow-Up

We submit claims promptly, track them through the payment lifecycle, and manage rejections, appeals, and resubmissions to accelerate reimbursements and minimize revenue delays.

Prior Authorization & Medical Necessity Support

We manage prior authorizations for specialty drugs, advanced treatments, and diagnostic services while ensuring complete documentation to meet payer medical necessity requirements.

Accounts Receivable (AR) & Denial Management

Our proactive AR team monitors outstanding claims, performs timely follow-ups, identifies denial trends, and resolves issues quickly to maintain consistent cash flow.

Reporting, Compliance & Revenue Analytics

Receive detailed reports on collections, denial rates, infusion revenue, and A/R performance. We stay current with CPT, HCPCS, ICD updates, and payer policies to ensure full compliance and financial transparency.

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Our Services

Better Billing Performance Backed by Data

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First-Pass Clean Claim Rate
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Reduction in AR Days
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I have been using 5 Star Billing Services, Inc. for over two years now. I am impressed with the detail and thoroughness that they consistently demonstrate. The team assigned to us is very familiar with the coding necessary for our specialty (chronic pain), and they excel at preventing rejections.

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Gary L. Child, D.O.

Medical Director

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Our Process

A Smarter Workflow Built for Hematology Billing

Our AI-Enhanced Billing Process

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Data Intake & Verification

Seamless integration with your EHR, practice management, and hematology documentation systems for efficient and accurate data flow.

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AI-Assisted Coding + Expert Review

AI-driven machine learning validates coding accuracy, while certified billing specialists review and ensure full compliance with payer and regulatory requirements.

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Claim Submission With Automated Follow-Up

Clean claims are submitted promptly with AI-enabled tracking and proactive follow-ups to accelerate payments and reduce delays.

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Payment Posting + Revenue Insights

Access a real-time dashboard with actionable insights on collections, denials, A/R, and payer trends—empowering smarter decisions and driving practice growth.

Continuous Expert Oversight

Every step is monitored by senior billing analysts specializing in hematology billing

Seamless EHR & Hematology Software Integration​

No workflow disruptions. Our team adapts to your clinical system and billing tools, supporting efficiency from day one.

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Commonly Used  CPT and ICD Codes in Hematology

Hematology CPT Codes

Evaluation & Management (E/M)

  • 99202–99205 – New patient office visits

  • 99211–99215 – Established patient visits

 

Infusion & Injection Services

  • 96365 – IV infusion, initial (up to 1 hour)

  • 96366 – Each additional hour of infusion

  • 96372 – Therapeutic/prophylactic injection (e.g., B12, iron)

  • 96374 – IV push, single medication

 

Blood & Transfusion Services

  • 36415 – Routine venipuncture

  • 86900–86901 – Blood typing

  • 36430 – Blood transfusion

 

Chemotherapy / Specialty Drug Administration

  • 96413 – Chemotherapy administration, IV infusion (initial)

  • 96415 – Each additional hour of chemotherapy infusion

 

Diagnostic Testing

  • 85025 – Complete blood count (CBC) with differential

  • 85027 – CBC without differential

  • 80053 – Comprehensive metabolic panel

Anemia Disorders

  • D50.9 – Iron deficiency anemia, unspecified

  • D51.9 – Vitamin B12 deficiency anemia

  • D64.9 – Anemia, unspecified


Coagulation & Blood Disorders

  • D68.9 – Coagulation defect, unspecified

  • D69.6 – Thrombocytopenia, unspecified

  • D70.9 – Neutropenia, unspecified


Blood Cancers & Serious Conditions

  • C90.00 – Multiple myeloma, not in remission

  • C91.10 – Chronic lymphocytic leukemia (CLL)

  • C92.00 – Acute myeloblastic leukemia


Other Hematologic Conditions

  • D57.1 – Sickle-cell disease without crisis

  • D72.829 – Elevated white blood cell count


Why Hematology Providers Trust 5 Star Billing Services

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AI-powered claim validation reduces errors, denials, and delays in high-cost hematology treatments.

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Certified hematology coding experts ensure accurate billing for infusions, specialty drugs, and complex therapies.

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End-to-end revenue cycle management improves collections and stabilizes cash flow for hematology practices.

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Proactive denial management and payer follow-ups accelerate reimbursements and prevent revenue leakage.

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Real-time reporting and analytics give you complete visibility into infusion revenue, A/R, and financial performance.

Frequently Asked Questions

Hematology billing involves high-cost medications, infusion therapies, frequent lab testing, and strict payer requirements. Services often require prior authorizations, precise drug coding (J-codes), dosage documentation, and medical necessity support. Even small errors can lead to denials, underpayments, or payment delays.

We use certified coding specialists and AI-assisted validation to ensure correct CPT, HCPCS, and J-code selection, accurate unit reporting, and proper use of modifiers such as JW for drug wastage. This helps prevent underbilling, reduces denials, and ensures full reimbursement for high-cost treatments.

Yes. We manage prior authorizations for specialty medications, infusion therapies, and advanced diagnostic services. Our team verifies payer requirements, tracks approvals, and ensures all clinical documentation meets medical necessity guidelines to avoid claim rejections.

Our process includes AI-powered claim scrubbing, payer-specific rule checks, proactive denial management, and timely follow-ups. We identify denial trends, correct root causes, and resubmit claims quickly—helping improve clean claim rates and accelerate reimbursements.

We provide detailed, real-time reports on collections, denial rates, days in A/R, infusion revenue performance, and outstanding balances. This gives hematology practices full visibility into financial health and helps identify opportunities to improve revenue cycle performance.

Benefits of Outsourcing Hematology Medical Billing

Specialty-focused billing expertise ensures compliance, efficiency, and consistent cash flow.

Focus on Patient Care, Not Administrative Burden

Free your clinical and administrative staff from complex infusion, drug billing, and authorization tasks so they can focus on delivering quality patient care.

Fewer Denials & Faster Reimbursements

Accurate coding for specialty drugs, J-codes, units, and modifiers—combined with proactive follow-ups—reduces claim rejections and accelerates payments.

Improved Cash Flow & Revenue Predictability

Efficient claims processing and strong A/R management help maintain consistent revenue from high-cost hematology treatments and multiple payers.

Scalable Support for Growing Hematology Practices

Whether expanding infusion services or patient volume, our billing solutions scale with your practice—without the need to hire additional staff.

Compliance & Risk Protection

Stay aligned with evolving CPT, HCPCS, payer policies, and medical necessity requirements to avoid underpayments, audits, and revenue loss.

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Our Tailored Hematology Billing Service is ideal for

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Solo hematology specialist in private practice

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Multi-specialty group practices that offer hematology services

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Surgical centers, hospital units, and ambulatory surgical centers (ASCs)

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Practices operating across multiple states or with complex payer mixes

AI-powered anesthesia coding services

AI-Powered Compliance & Precision: Why 5 Star Billing Leads in Hematology

  • Proven expertise in medical billing and revenue cycle management across 40+ healthcare specialties.
  • Certified hematology coding specialists trained in psychotherapy, psychiatry, and payer-specific compliance requirements.
  • AI-powered workflows that improve coding accuracy, reduce denials, and accelerate reimbursements.
  • Nationwide support for providers in all 50 U.S. states, regardless of location or payer mix.
  • A results-driven approach focused on compliance, clean claims, and maximizing your practice’s financial performance.

Simplify Your Hematology Billing Today

Contact us today to learn how we can tailor our hematology billing service across any state.

Contact Information

Phone

+1-480-999-0180

Email

info@drbillingservice.com

Service Area

Nationwide Service

CPC Certificate
HIPAA certificate
BBB A+-01

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