Like many other areas of specialization in medicine, medical billing and coding for urology are complicated processes and errors are common—and costly. With procedures ranging from minor in-office actions to major procedures requiring hospital stays and follow-up treatments, getting all the coding right, and not overlooking anything is a source of frustration for many practices.
In order to stay solvent as a business, it is important to get paid for all services rendered, which requires making sure that the coders and billers understand all the procedures, and the variables for each one. The correct use of modifiers in coding is also critical in these complex situations, but even the smallest of errors can result in a claim rejection or denial, which essentially starts the coding and billing process all over for each claim that isn’t accepted.
Medical Billing Challenges for Urology Practices
Rarely used codes—Medical billers who enter the same codes every day become quite familiar with them, but highly specialized procedures are not performed very often, so the coding may not be well understood, resulting in errors.
Once a procedure has been performed and a claim submitted, payers often deny coverage of that item, but often the claim is legitimate and a coding error has been included that does not correctly indicate what was done. One common reason for this is that the coding for the tests that demonstrated that the procedure was medically necessary are missing. It doesn’t matter if the rest of the documentation makes it obvious that it was necessary, the coding requirements must be followed, literally, to the letter.
Under-coding and over-coding
Failing to include all the subcategory coding and modifiers needed to correctly bill for services results in under-coding and a loss of revenue. It is illegal, so can lead to serious problems, and must be avoided even in an effort to save a patient money. Clearly overcoding, or coding for services that were not performed is illegal also, but can occur just by entering a wrong code.
Medcare MSO’s Urology Billing Service Helps Your Practice Thrive
There are a lot of moving parts involved in running a urology practice, and it is important that revenue cycle management doesn’t become a hindrance to the most important things happening—doctors and nurses treating patients. It is not possible for a physician, or even the administrator of a busy office to keep up with all the billing practices and coding changes involved with urology billing.
Medcare MSO specializes in coding and billing, so it is our business to bring innovation and efficiency into the revenue cycle, and enhance our clients’ bottom lines by eliminating errors and speeding up the billing process, resulting in faster payments to you. We manage the complete cycle from scheduling through bill collection. Our certified coders are experienced in urology, so they understand which codes are required and our process is designed to include a review of every claim to ensure that all needed information is there and that it all makes sense.
Our proprietary software incorporates all the codes needed to fully communicate what was done and to submit claims that get accepted the first time around. If something is denied or rejected, our staff are specialists at finding the problem, correcting the claim and getting it through the process to get you paid. Get a free demo today. We look forward to showing you just how much money we can save you wile making your office run more smoothly.