Urology Billing Services

Surgical global periods, in-office procedures and the lab and imaging most urology practices under-bill.

Urology mixes office procedures, surgery and ancillary services in a way few specialties do. The billing errors follow that mix. A cystoscopy bundled into an office visit. A global period misread after a stent. Urodynamics billed without the professional component. Our urology billing services code each setting on its own rules.

Practices comparing urology medical billing services should ask about the ancillaries in particular. In-office pathology and urinalysis need a CLIA certificate at the right complexity level, and the CLIA number has to be on the claim. Bill above your certificate and you have a compliance problem, not just a denial.

Our Services

Where Urology Practices Lose Money

Urology billing needs real expertise to run cleanly. Underpayment on postoperative complications, urodynamics and infusion immunotherapy eats into your revenue quietly. Our urology billing services give your practice a team that watches for it.

Key Attributes of Our Medical Billing Services:

  • Charge Entry

    Your claims come to us and go straight into our billing software. We aim for better than 98% accuracy within 24 hours. We get there by automating the routine steps, handling patient data carefully, checking eligibility, and talking to insurers quickly. Our urology billing services code office procedures, surgery and ancillary work on their own rules, because a cystoscopy swallowed into an office visit is a cystoscopy you never got paid for.

  • Claim Scrubbing

    Scrubbing checks the setting before the code. An office cystoscopy is separated from the E/M with the right modifier. A global period is read correctly after a stent. Urodynamics is split into its professional and technical parts.

  • Insurance and Rejection

    Urology rejections come mostly from bundling and from in-office ancillaries. We check your CLIA certificate level against every lab code billed. A test above your certificate is a compliance problem, not just a denial.

  • Payment Posting

    Surgical, office and ancillary payments go into separate buckets, and each is checked against the contracted fee schedule. That way an underpaid surgical code is not hidden by healthy office collections.

  • Patient Statements

    Statements are held until the global period closes. A patient should never be billed for a post-operative visit that the surgery already covered.

    Illustration of a doctor writing a prescription for a patient

  • Optimize Efficiency

    We audit the in-office procedure list every month. Urology practices do cystoscopies, biopsies and catheter changes that get swallowed into an office visit and never billed as procedures.

  • Timely Claim Submission

    Claims go out within 48 hours. Surgical claims are held only long enough to confirm the operative note supports the modifier we chose.

  • Reporting

    Reporting separates surgery, office procedures and ancillaries. That is the breakdown a urology practice needs to see where its margin really comes from.

Procedure

Every day, we handle various Urology Billing procedures, including but not limited to:

  • EndoUrology
  • Reconstructive Urology
  • Urologic oncology
  • Pediatric Urology
  • NeuroUrology
  • Female Urology
  • Laparoscopy
  • Andrology

Three settings, three sets of rules

Urology bills office work, surgery and ancillary services, and each one follows different rules. Most errors happen where they meet.

Office procedures and the visit

A cystoscopy done in the office is a procedure with its own code and its own short global period. The visit that day is billable as well, but only when there was a separate evaluation, with the right modifier and a note that stands on its own without the procedure in it.

Adding a visit to every procedure is a pattern payers look for. Dropping it every time gives away real money. The note decides, and it should be written so that it does.

Urodynamics is billed by component

A urodynamic study is several separate services, not one: the flow study, the cystometrogram, the pressure studies, the electromyography. Each has its own code, and each splits into a professional and a technical part.

Where the practice owns the equipment and interprets the study, the global service is billed. Where it does not, only the interpretation is. Practices being paid a fraction of what they expected for urodynamics are almost always billing the wrong component, and it repeats on every claim until somebody checks a payment against the fee schedule.

Global periods after stents and scopes

Stent placement and removal carry global periods, and the removal is sometimes included in the placement and sometimes not, depending on the codes used. Getting this wrong in either direction is common. Writing off the removal when it was separately payable is the more expensive version.

In-office laboratory

Urinalysis and in-office pathology need a CLIA certificate at the right complexity level, and the CLIA number has to be on the claim. Billing a test above the level your certificate covers is a compliance problem rather than a denial, and it is worth checking what your certificate actually permits rather than assuming.

Urology Credentialing, ASC Privileges and In-Office Lab

Urology credentialing covers more ground than most physician specialties. Payer enrollment through CAQH and PECOS is the easy part. Hospital privileges come next, and you need them before any inpatient work, stone case or robotic procedure. Robotic privileges are often granted separately, with their own training and case log requirements.

Then there is the in-office side. Many urology practices run their own laboratory and pathology, and that lab needs a CLIA certificate before the technical component is billable. In-office lithotripsy, urodynamics and imaging each carry their own supervision and enrollment rules. Bill any of them without the right enrollment and the denials arrive months later.

We handle physician enrollment, privileging and the in-office lab and imaging side together. See our medical credentialing services.