Oncology EHR and AI Medical Billing Software

Oncology claims are among the largest a practice sends, and the most closely reviewed. XEHR connects treatment plans, administration records, authorizations and claims.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Cycle 3 visit; tolerating treatment well.

C50.911 Breast cancer, right

ReviewSign note

Diagnosis carried to the claimC50.911

THE HARD PARTS

What makes oncology billing hard

High-cost drugs, high-risk claims

A single infusion claim can be worth thousands. A missing authorization, dose detail or wasted-drug record means a costly denial.

Authorizations for every regimen

Regimens and their supporting drugs need approval, often with pathology and staging attached.

Patients worried about cost

Patients need to know what they will owe before treatment starts.

WHERE THE WORK HAPPENS

How oncology care is delivered and billed

Medical oncology is built around treatment cycles. Office visits, chemotherapy and immunotherapy infusions, supportive drugs and lab work all happen in the practice, and each infusion day can carry several drugs and hours of administration on one claim. Drug costs dominate revenue, which makes prior authorization, correct units and timely filing the difference between a sustainable practice and a losing one.

What payers check on oncology claims

Chemotherapy administration is billed by method and time, with the first hour and each additional hour counted separately.
Drug units billed must equal the dose given in the units defined for each drug code, with documented waste where payers require it.
Most chemotherapy and immunotherapy drugs require prior authorization tied to the diagnosis, stage and line of therapy.
The encounter for chemotherapy is coded first when the visit is for treatment, followed by the cancer diagnosis.
Supportive drugs such as growth factors have their own coverage criteria, usually based on documented risk of low blood counts.

Common oncology diagnoses ICD-10-CM

C50.911	Malignant neoplasm of unspecified site of right female breast
C34.90	Malignant neoplasm of unspecified part of unspecified bronchus or lung
C18.9	Malignant neoplasm of colon, unspecified
C61	Malignant neoplasm of prostate
Z51.11	Encounter for antineoplastic chemotherapy
D70.1	Agranulocytosis secondary to cancer chemotherapy

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

An oncology visit, start to payment

1
Approve the regimen

The treatment plan is documented with the diagnosis and stage, and every drug that needs prior authorization is flagged before the first cycle.
2
Check labs on the day

Counts and chemistries are in the chart before treatment, so the hold-or-treat decision is documented in one place.
3
Infuse and record

Each drug, dose, unit, start and stop time is recorded during the infusion, along with any reaction.
4
Bill the cycle

Drugs, administration and the visit go on one checked claim; the next cycle and its approvals are already in view.

How XEHR helps

From the oncology visit to the payment

Administration documented in fullDrug, dose, route and time are captured so the claim matches what was given.
Authorizations prepared and trackedRequests are built from the chart and tracked to approval and renewal.
Coverage checked aheadEligibility and benefits are checked before treatment so the patient can be told what to expect.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for oncology

AI medical billing for oncology practices

XEHR is an agentic EHR: AI agents do the administrative work around every oncology visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Chemotherapy administration is billed by method and time, with the first hour and each additional hour counted separately.
Drug units billed must equal the dose given in the units defined for each drug code, with documented waste where payers require it.
Most chemotherapy and immunotherapy drugs require prior authorization tied to the diagnosis, stage and line of therapy.
The encounter for chemotherapy is coded first when the visit is for treatment, followed by the cancer diagnosis.

Around the visit

Agents run on their own

Coverage checked before each oncology visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose an oncology EHR

Ask every vendor, including us. The answers show whether a system was built for oncology work or only adapted to it.

Ask us on a demo

Are prior authorizations tracked per regimen, so no cycle is given on an expired approval?
Does the infusion record capture every drug, unit and minute for the claim?
Can the hold-or-treat decision be documented with the day’s labs?
How are growth factors and other supportive drugs checked against coverage criteria?
Can the next cycle and its approvals be seen while the current one is billed?

QUESTIONS

Oncology practices ask us

Does XEHR handle chemotherapy and infusion billing?

Yes. Administration details from the note carry onto the claim, and the claim is checked before it goes out.

Can XEHR help with oncology prior authorizations?

Yes. Requests are prepared from the chart and tracked, and your staff reviews and submits them.

Does XEHR handle chemotherapy infusion billing?

Yes. Drugs, units and administration times are captured in the infusion record and carried to the claim.

Can XEHR track approvals for each treatment cycle?

Yes. Approvals are tracked against the regimen, so a cycle is not given on an expired authorization.

Does XEHR support clinical trial patients?

Yes. Research and routine services can be separated on the claim as payers require.

Can oncology practices see when an approval expires?

Yes. Each approval is tracked with its end date on the patient’s record.

How much does XEHR cost for an oncology practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take an oncology practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

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See XEHR set up for oncology

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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