The situation becomes even more complicated when it comes to urology billing. Medical billing is a highly complex field that requires experience-based knowledge and expertise to deal with insurance companies. Only a company staffed with well-trained urology billing professionals can handle such complexities. The medical billing and coding specialist must be well-versed in the urology billing process world’s codes and billing rules. As the cost of providing urology-related healthcare services rises, healthcare providers and urology practices cannot afford to lose revenue due to incorrect urology billing and coding. Not only is insurance billing more difficult in urology, but patient billing is also more difficult.
Patients frequently have high balances, complex explanations from their payers, and need help understanding the invoices they receive from their urologist. A medical billing company with extensive urology billing experience has previously spoken with the patient about such statements. A less skilled patient collection effort may result in more money and happier patients for the urologist. Therefore, urologists must know the dos and don’ts of the urology billing process to avoid all billing pitfalls.
Dos for Urology Billing Process
- Do Ensure Correct Patient Information
Patient verification information is critical for reimbursement while submitting the claims. After the visit, obtain the patient’s insurance information, such as date of birth and Social Security number, as well as the patient’s home address for demography purposes and any special notes from the doctor. More than just collecting the information is required; verifying the accuracy and correctness also demands attention. Precise patient information will allow urology claims to be approved and reimbursed more quickly.
- Do Select the Right Code in Less Time
When performing CPT coding for urology, there are three major categories to consider:
E/M Codes: These are most commonly found between 99202 and 99499 and are used for billing professional services such as hospital visits, physician and nonphysician clinic visits, or consultations.
Procedure Codes: These are the codes used to bill for diagnostic and treatment services, and they are typically found between 50010 and 58999.
Add-on Codes: These codes identify procedures performed in addition to the primary procedure, denoted by the “+” symbol. If reported with the appropriate primary procedure, these codes may be payable.
Knowing these broad categories and where to find them can help you narrow the field significantly when choosing a code. Once you’ve determined what type of code you’re looking for, the chart notes should identify the diagnoses and procedure(s) performed to assist you in selecting the best option by providing essential details of the services performed for the patient on that date of service.
Don’ts for Urology Billing Process
- Don’t Under code to Avoid an Audit
Under coding is the practice of selecting codes that do not capture all of the work done. Most of the time, this is due to oversight. But some practices do it intentionally to reduce the likelihood of an audit. Under coding causes revenue loss because work needs to be reported, but it also causes a skewed data pattern. That raises a red flag for Medicare, which is actively looking for deviations to investigate.
At some point in the process, almost everyone will be audited. The best way to proceed is to keep staff updated on coding best practices and document everything you do.
- Don’t Forget the Clearinghouse
Did you know? A clearinghouse aims to ensure that each urology claim submitted is error-free. A well-designed and defined clearinghouse detects errors, reducing the risk of claim denial. If you do not have a clearinghouse, your chances of submitting an apparent claim decrease. Always keep in mind that submission and resubmission require additional time and resources, resulting in a deficit in both time and money for your urology practice.
Outsource your Urology Billing Process!
Are you a urologist who needs help streamlining your medical billing? Is your medical organization unable to locate the appropriate resources to handle your urology billing needs? Are you confused regarding the dos and don’ts of your urology billing process? Then, you should consider outsourcing urology billing services to an experienced and skilled service provider.
24/7 Medical Billing Services is one such urology billing company that can be a one-stop shop for all your urology billing requirements. We use some of the best and most up-to-date medical billing tools and technologies to ensure error-free billing services. We have the most skilled and talented medical billing specialists on staff who can efficiently handle all of your needs. We offer our clients highly customized urology billing services that are tailored to their specific medical practice needs.