Clientele's oncology intelligence platform sequences chemotherapy and infusion claims, maps J-codes, tracks prior authorizations, and validates medical necessity, so every treatment cycle reaches the payer clean the first time.
Eight clinical domains feed into a single revenue outcome.
Multi-drug regimens sequence differently by protocol and cycle.
Checkpoint inhibitors and biosimilars carry distinct J-code logic.
Concurrent radiation and systemic therapy billing must stay separated.
Infusion time, sequencing, and push-vs-drip coding change reimbursement.
High-cost biologics require prior authorization tied to diagnosis codes.
Anti-nausea, growth factor, and hydration codes bill alongside treatment.
Treatment plans must justify every drug, dose, and cycle billed.
Diagnosis, staging, and protocol must align with payer policy.
Five modules validate every infusion claim before it ever reaches a payer.
Confirms every drug order matches an active NDC and correct J-code.
Validates push, drip, and multi-drug sequencing against payer rules.
Maps every biologic and chemotherapy drug to its current J-code.
Confirms staging and diagnosis codes support the billed protocol.
Predicts denials before submission using oncology-specific claim patterns.
Every treatment cycle passes through all six before it reaches a payer.
Confirms protocol, drug, and cycle align with diagnosis before ordering.
Keeps every biologic and chemotherapy J-code current against payer bulletins.
Scores prior-auth requests for approval likelihood before submission.
Checks chart documentation against billed administration codes.
Runs a final payer-specific check before a claim ever leaves the building.
Identifies underpaid claims and coding opportunities across your payer mix.
Select a service to see how Clientele handles its billing workflow.
Systemic therapy planning, cycle management, and drug-specific coding for solid tumors.
"Our J-code accuracy alone eliminated most of our infusion denials. Clientele understands oncology billing the way our best coders do."
"Prior authorization used to hold up treatment starts. Now our approvals move as fast as our treatment plans."
"The infusion sequencing logic caught errors our previous system never even flagged."
Our engine tracks payer bulletins and NCCN updates continuously, keeping every biologic and chemotherapy J-code current before a claim is submitted.
Yes. Clientele’s authorization prediction scores each request before submission using payer-specific historical patterns.
Clientele checks push-versus-drip logic, administration time, and multi-drug sequencing against payer infusion policy before the claim goes out.
Documentation is checked against billed units so waste is captured and reimbursed correctly under payer-specific rules.
No. Clientele’s AI layer works alongside your coding team, validating claims and surfacing issues before submission.
Most oncology and infusion practices are fully live within 4 to 6 weeks, including payer and EHR configuration.
