Hematology RCM

AI-Powered RCM Built for Hematology & Oncology Practices

Q: How does QuickIntell handle J-code unit calculation and JW wastage?

QuickIntell reviews the infusion order, dose, NDC package size, payer policy, administered amount, and discarded amount to calculate HCPCS J-code units. It flags mismatches, suggests JW modifier use where discarded drug must be reported, and routes exceptions to coders before claim submission.

Q: Does it integrate with Epic Beacon / Flatiron OncoEMR?

Yes. QuickIntell supports oncology and hematology integration patterns for Epic Beacon and Flatiron OncoEMR, with implementation-scoped options across FHIR, HL7, API, file exchange, or workflow automation depending on the customer's source system and contract scope.

Q: How fast is PA for daratumumab/rituximab?

Clean daratumumab or rituximab packets can be drafted in minutes once eligibility, diagnosis, treatment plan, labs, prior therapy history, and payer policy criteria are available. Payer turnaround still depends on the payer and channel, while QuickIntell tracks receipts, status, renewals, and appeal paths.

Q: Does it flag 340B-eligible claims?

QuickIntell can flag potential 340B eligibility when configured with covered-entity, site, prescriber, payer, drug, NDC, and acquisition data. Flags should route through the customer's pharmacy and compliance review before claim, split-billing, or adjustment decisions are finalized.

Q: How does it prevent CO-50/CO-197 denials in heme/onc?

QuickIntell checks medical-necessity policy, LCD/NCD and payer rules, diagnosis-code fit, prior-authorization status, units, modifiers, NDC detail, and required documentation before submission. High-risk heme/onc claims are blocked or routed for correction before they become CO-50 or CO-197 denials.

Q: Is it HIPAA + HITRUST compliant?

QuickIntell is built for PHI workflows with BAAs, encryption in transit and at rest, RBAC, tenant isolation, and audit logging. HIPAA commitments and current HITRUST evidence should be validated through the Trust Center or security package during procurement and compliance review.

QuickIntell helps hematology and oncology billing teams manage biologic prior auth, verify J-codes and NDC detail, close infusion charge capture gaps, and prevent oncology denials before claims leave connected EHR workflows.

<1 day

Biologic PA target

95-97%

J-code clean claims

55-65%

Oncology denial recovery

98%+

Infusion EHR parity

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Hematology revenue cycle team reviewing oncology billing workflow

TL;DR

Built for biologic PA, J-code billing, and oncology denial prevention.
Integrates with Epic Beacon, ARIA, Mosaiq, OncoEMR, and Flatiron.
Security posture covers HIPAA, SOC 2 Type II, and HITRUST.

Hematology workflow

PA -> coding -> claims -> denials -> AR

QuickIntell keeps hematology revenue work connected from the first authorization check through coding validation, claim submission, denial response, and AR follow-up.

Authorization intake

Eligibility, payer rules, diagnosis support, drug units, and clinical attachments are checked before the biologic or infusion request is submitted.

Coding

Heme/onc code review

ICD-10, CPT, HCPCS J-codes, modifiers, NDC detail, and wastage evidence are reviewed against the note and treatment plan.

Claims

Clean claim assembly

Approved units, auth numbers, payer edits, NCCI/MUE checks, and claim attachments move forward only after pre-submission validation.

Denials

Reason-code triage

CO-50, CO-197, CO-A1, medical-necessity, authorization, and missing-information patterns route to the right owner with the original claim context.

Follow-up and recovery

Open balances, appeal deadlines, payer responses, corrected claims, and recovery outcomes stay tied to the encounter and billing record.

Connected QuickIntell workflows

Biologic prior authorizationPacket assembly, renewal tracking, and payer status checks for recurring therapy.Eligibility verificationCoverage context before PA, coding, and clean-claim assembly.Coding notes reviewClinical note, ICD-10, CPT, HCPCS, modifier, and NDC validation.QuickCodeAI-assisted code review for hematology and oncology billing teams.Claims processingPre-submission claim checks before payer submission.Denials managementCO-50, CO-197, and missing-information workflows tied to claim context.Epic integrationIntegration planning for Epic Beacon and connected oncology workflows.

Coding deep dive

Heme/onc coding checks for complex therapy claims

High-cost hematology claims need diagnosis specificity, drug-unit math, infusion hierarchy, and modifier review before payer edits turn into rework.

D50-D89 specificity

Flags anemia, coagulation, immune, and blood-disorder ICD-10 specificity gaps before coders finalize the claim.

J-codes and NDCs

Compares administered drug, NDC package, units, site of service, and payer billing requirements for high-cost therapies.

96365-96417 CPT logic

Checks infusion, injection, chemotherapy, initial, sequential, concurrent, and additional-hour coding relationships.

JW modifier review

Surfaces discarded-drug documentation needs and wastage lines so the billing team can validate before submission.

Biologics prior auth

Recurring therapy packets without repeated manual rebuilds

QuickIntell assembles the clinical, coverage, and payer-policy evidence that hematology teams need for biologics and infusion-cycle authorizations.

Biologics prior auth checklist

Daratumumab, rituximab, IVIG, iron infusion, and other biologic templates
Diagnosis, lab, stage, line-of-therapy, and prior-treatment evidence
Payer portal, EDI 278, fax packet, receipt, and status tracking
Renewal calendars for recurring therapy cycles and expiring approvals

Denial playbook

Prevent and work the denial codes hematology teams see first

The denial workflow links payer reason codes back to authorization state, coding decisions, attachments, and appeal evidence so teams can fix root causes instead of reworking claims blind.

CO-50

Medical necessity

Compares the diagnosis, documentation, policy criteria, and treatment plan before the claim leaves the queue.

CO-197

Missing authorization

Checks that approval numbers, effective dates, units, and service windows match the billed therapy.

CO-A1

Claim/authorization detail

Routes payer requests for missing or conflicting claim information with source documents attached for faster response.

Oncology EHR integrations

Connect hematology RCM to oncology source systems

QuickIntell maps scheduling, orders, notes, coverage, authorization status, charge detail, claim status, and payment write-back around the oncology EHR your team already uses.