How a Large Oncology Group Reclaimed $1.25 Million in Missed Revenue with Practolytics’ Specialty Coding Audit

A 40-provider oncology group discovered major revenue leakage from under-coding in infusion and radiation services.
Practolytics performed a specialty-focused audit reviewing 1,200 encounters and uncovered recurring issues like missed wastage, incorrect infusion units, and missing modifiers.
720 claims were corrected and reprocessed, resulting in $1.25M recovered in seven months.
Coding accuracy improved from 78% to 96%, and oncology-related denials dropped by 54%.
Training was provided to nurses, coders, and clinicians, plus quick-reference oncology coding guides.
The practice gained smoother cash flow, stronger documentation-billing alignment, and a projected $1.1M annual uplift.
Key takeaway: Specialty-specific audits and ongoing monitoring prevent long-term revenue loss.

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A 40-provider oncology group discovered major revenue leakage from under-coding in infusion and radiation services.
Practolytics performed a specialty-focused audit reviewing 1,200 encounters and uncovered recurring issues like missed wastage, incorrect infusion units, and missing modifiers.
720 claims were corrected and reprocessed, resulting in $1.25M recovered in seven months.
Coding accuracy improved from 78% to 96%, and oncology-related denials dropped by 54%.
Training was provided to nurses, coders, and clinicians, plus quick-reference oncology coding guides.
The practice gained smoother cash flow, stronger documentation-billing alignment, and a projected $1.1M annual uplift.
Key takeaway: Specialty-specific audits and ongoing monitoring prevent long-term revenue loss.