Urology billing is tricky. It’s part of the medical billing field, which is very complicated. You need people who know a lot and have experience in dealing with insurance companies.
A company needs to have urology billing experts. These experts must know all the codes and rules for urology billing.
The cost of urology healthcare is going up. So, healthcare providers and urology practices need to get the billing right.
Urology insurance billing is complex. Patient billing is tricky, too.
Patients often have big bills and complicated explanations from their insurance. They also need help understanding the statements from their urologist.
Professional medical billing service with lots of experience in urology has talked to the patient about these bills before. If the collection process is not done well, the urologist might get more money and have happier patients.
So, urologists must learn the right and wrong ways to do billing in urology to avoid problems.
Tips for Urology Billing
Make Sure You Get the Patient’s Info Right
When you’re sending in bills, it’s super important to have the patient’s correct info. So, after their visit, get their insurance details like birthdate and Social Security number. Also, note down their home address and any special notes from the doctor for records. It is not just about gathering info; you must check that it’s correct. Having the right patient info helps urology claims get approved and paid faster.
Choose the Right Code Quickly
When coding for urology, there are three main code types to think about:
- E/M Codes: These are for things like doctor visits and consultations, and they usually have numbers between 99202 and 99499.
- Procedure Codes: These are for treatments and tests and usually have numbers between 50010 and 58999.
- Add-on Codes: These procedures are done along with the main one, with a “+” symbol. If you use them with the primary process, you can get paid for them.
Knowing these big categories and where to find them can make it easier to pick the correct code. After you know what kind of code you need, look at the patient’s chart to see what was done on that day. This will help you pick the best code by giving you essential details about the services done for the patient.
Check Provider Details
Once you’ve checked the patient info, it’s important to double-check it. When sending a urology claim, ensure you have the correct address and contact info for your urology center. Also, include your ID numbers and EDI processing numbers.
Using a Clearinghouse
To improve medical billing and coding and prevent mistakes, you should get help from a clearinghouse. A good clearinghouse will review your urology claims to ensure they’re error-free before sending them. If they find any mistakes, they’ll tell the billing person to fix them quickly. This helps avoid problems later with claims that are filed or coded incorrectly.
Things you should avoid for the Urology Billing Process
Fixing Denied Urology Claims
When a urology claim gets denied, there’s a valid reason. First, ensure it’s error-free before your team resubits it automatically. If there are wrong diagnosis codes, correct them and try again. Ask the attending urologist for the correct diagnosis codes, then resubmit the claim.
Do Not Use Few Codes to Avoid an Audit
Using too few codes means you need to describe all the work done. This happens either by mistake or on purpose to dodge audits. Coding makes you lose money because you must report all your work. It also looks suspicious to Medicare, which checks for unusual things.
Almost everyone will get audited eventually. To stay safe, teach your staff to use codes well and write down everything you do.
Remember the clearinghouse
Do you know what a clearinghouse is? It helps make sure your urology claims are correct. A good clearinghouse finds errors and makes it less likely your claims get denied. If you don’t use one, your chances increase. Remember, fixing and sending shares again takes time and money for your urology practice.
Need help with your urology billing? Are you a urologist or a medical organization struggling with billing? Need to know the rules? Consider outsourcing to experts!
Outsourcing Can be helpful
Are you a urologist looking to make your medical billing easier? Is your medical group having trouble finding the correct help for urology billing? Do you have questions about how to do urology billing correctly? If so, consider getting help from professional medical billing services in California to complete administrative work.
Key Takeaways
- Urology billing can be challenging due to its complexity, requiring expertise to navigate insurance intricacies.
- Incorrect billing and coding can lead to revenue loss, which is especially critical as the cost of urology healthcare rises.
- Verify and maintain accurate patient information.
- Confirm and provide accurate provider information.
- Urologists struggling with billing complexities should explore outsourcing urology