Specialized Urology Billing and Coding Services
At OneMed Billing Services, we offer specialised billing and coding services for urology practices and imaging centres. Our services cover all diagnoses and treatments related to issues with the male reproductive system and urinary system. However, billing for urological treatments can be more complex than other specialties due to the specific codes and terminologies used in urology.
Our team of urology billing specialists is uniquely qualified to handle the complexities of urology billing and coding. The intersection of urology with other specialties, such as oncology, gastroenterology, and pediatrics, makes it difficult to understand without specific knowledge and expertise.
Urologists often focus solely on providing medical care and can overlook their revenue cycle. Nonpayment or underpayment for services provided can have a significant negative impact on a practice, especially considering the high cost of urological operations. While an internal billing staff may be useful, they may result in a high volume of denials due to their inexperience. Outsourcing to a specialised urology billing service provider like OneMed Billing can give healthcare businesses more control over collections and denials, thanks to our knowledge of urology codes and terminologies.
Urological Procedures and Treatments
● Incisional/Biopsy
● Excision & Transplantation
● Introducing catheter
● Laparoscopic procedure
● Cystoscopy, Urethroscopy, Cystourethroscopy, etc.
● Remedies
Common Urology Billing and Coding Challenges
Urology billing and coding can be challenging due to the specific codes and terminologies involved. Below are some common challenges faced by urology service providers:
1. Prior Authorization: Urology operations are expensive, and insurance companies require prior authorization before providing the services.
2. Medical Requirement: Providers must justify the medical necessity of the course of treatment to charge appropriately for the highly expensive services they provide.
3. Verifying Patient Eligibility and Benefits: Providers should verify a patient's eligibility and benefits for a certain service at least 48 hours beforehand to decrease denials.
4. Invalid CLIA Number: Providers must update their Clinical Laboratory Improvement Amendments (CLIA) number when billing for lab tests.
5. Non-Covered A Codes: Medicare will not cover some A Codes, but some supplemental insurance may cover the cost of therapies not covered by Medicare.
6. Maximizing Benefits with Coding: Providers must code CPT codes with the appropriate units to maximize benefits according to what the individual payers allow.
7. Documentation for Catheter Insertion: Providers shouldn't record 51701-51703 in addition to any other treatment that has catheter insertion as a component.
8. Modifier 59: Practitioners must use modifier 59 when paying for two urological services simultaneously.
9. Adhering to LCD Rules: Providers should follow the Local Coverage Determination (LCD) rules before billing for urology services.
Urology Revenue Cycle Management with OneMed Billing Services
At OneMed Billing Services, we bring our expertise in urology billing and coding to help you establish a dynamic and denial-free revenue cycle management process. Our team of urology specialists allows you to focus on providing excellent patient care while we concentrate on improving your collections. Our experts are:
• Certified by the American Association of Professional Coders (AAPC) with the CUC certification and training in the most medical coding software
• Experienced in processing medical claims with major commercial insurance providers, including UHC, WellPoint, Aetna, Humana BCBS, and Anthem, as well as government payers like Medicare
• Knowledgeable in utilizing Medicare and understanding Medicaid policies that vary from state to state
• Skilled in cost-cutting strategies that can help you enhance clinical and operational effectiveness
• Equipped with a dedicated prior authorization team to ensure accurate patient data collection.