Every healthcare organization wants to get paid faster from payers. Do you also want? Improving your urology billing processes can help. However, you should focus on the tips that will improve the revenue cycle and the errors that are contributing to decreasing revenues.
Accurate coding and billing are necessary for the overall success of healthcare providers. You should adopt services to manage crucial challenges such as claim submission, insurance verification, and coding compliance. You can manage urology billing challenges by hiring a professional billing company like SysMD.
In this blog post, we will dive into the details of urology medical billing. Further, we will discuss how outsourcing an experienced company can lead you to get paid faster.
Understanding Urology Medical Billing: Key Components
Every billing strategy covers a complete process from claim submission to denial management. Every step is important, but the most complex step is considered coding. CPT and ICD-10 codes are key components of urology medical billing.
CPT Codes for Urology
Some important CPT codes that are used in claims submission are as follows:
Office Visits & Consultation Codes
- 99201–99215 – Evaluation and management (E/M) office visits
- 99241–99245 – Outpatient consultations
- 99221–99223 – Initial hospital care
Common Urology Procedures
- 52000 – Cystourethroscopy (diagnostic)
- 52001 – Cystoscopy with irrigation and clot evacuation
- 52005 – Cystoscopy with ureteral catheterization
ICD-10 Codes for Urology
Some crucial diagnostic codes by ICD-10 are as follows:
Urinary Tract Infections (UTIs)
- N39.0 – Urinary tract infection, site not specified
- N30.00 – Acute cystitis without hematuria
Benign Prostatic Hyperplasia (BPH)
- N40.0 – Enlarged prostate without lower urinary tract symptoms (LUTS)
- N40.1 – Enlarged prostate with LUTS
Prostate Cancer
- C61 – Malignant neoplasm of prostate
- Z85.46 – Personal history of malignant neoplasm of the prostate
Prostate Cancer
- N52.9 – Male erectile dysfunction, unspecified
- N52.01 – Erectile dysfunction due to arterial insufficiency
Billing Documentation Practices
Documentation is also an important part of medical billing for urology. Insurance and private payer companies reject those claims that do not follow accurate documentation practices. Some beneficial practices are as follows:
- Mention the medical necessity in every claim.
- Complete the patient data such as name, MR number, and history in EHR systems.
- Verify the insurance eligibility of the patient and then process the claim.
- All the required documents according to payer guidelines should be attached to claims.
Common Errors in Medical Billing for Urology & How to Avoid Them
Fixing urology billing issues is impossible until you find their reasons, it means the errors. You should know the errors in your billing practice so that you can work on them and solve them. To avoid delays and rejections, it’s crucial to follow error-prevention practices.
Common urology billing mistakes with their solutions are as follows:
- Learn more in our Billing Mistakes Guide.
Incorrect Coding
Urology coding errors are one of the main reasons for late reimbursements. A code specifies the medical necessity and diagnosis of the patient. If it is wrong, how a payer company will pay for the specific service of the patient? Further, using outdated codes also leads to coding compliance issues for the hospitals. So, use codes that are accurate and according to updated lists of CPT and ICD-10.
Compliance Issues
Medicare and CMS have specific billing guidelines for every billing department. When hospitals are unable to adapt these guidelines in their routine practice, they face compliance issues. Insurance companies also do not pay faster to those who are non-compliant in their practice. So, follow proper billing guidelines and documentation practices according to CMS and Medicare.
Lack of Proper Documentation
Medical billing mistakes also include a lack of proper documentation. When medical staff do not add complete history and patient data, they generate errors in the bills. It also led to underpayment issues. Thus, fixing urology billing issues includes fulfilling complete document requirements. Documents should include previous service data, history, name, and MR number of the patient.
Benefits of Outsourcing Urology Medical Billing Services
Why outsource medical billing? Obviously to improve cash flow and revenue cycle. Third-party billing can improve your in-house billing system. Usually, medical staff have a heavy workload, which is why, they make a lot of mistakes in billing processes. Urology billing experts can enhance the practice profitability and claim processing efficiency of your hospital.
Choosing a urology billing service can provide you with the following benefits:
Improve Operational Efficiency
The operational efficiency of every hospital depends on its billing system. Professional billing companies can take over all the billing systems of your hospital. They can streamline important billing tasks efficiently. So, you can improve the operational efficiency of your organization.
Improve Revenue Cycle
Revenue Cycle Management is necessary for the financial stability of a hospital. Outsourcing urology medical billing services can improve the revenue cycle. Professional billers work on audits regularly and extract ways to improve revenues daily. Further, they also maximize the chances of claim approvals so that revenues can increase.
Handle Complex Coding
As we discussed above coding is considered a complex system. Standard billing companies recruit professional coders who know how to put accurate urology codes in the claims and bills. They also understand the importance of coding compliance and use updated codes in the claims. Thus, they streamline the coding system to get you paid faster.
Reducing Administrative Burden
Outsourcing vs in-house billing, which is better for medical staff? Billing is a lengthy procedure, and medical staff cannot handle patient care and billing issues at the same time. You can get help from professional urology billing specialists to reduce the administrative burden of your hospital. Professional urology billing specialists can reduce the administrative burden of your hospital. Explore our urology billing guide to strengthen your billing system further. In this way, you can also reduce common billing errors.
Optimizing Revenue Cycle Management for Urology Practices
Improving the revenue cycle in urology is considered cumbersome. Do not worry, we can make it easy for you. Here is a step-by-step guide to optimize revenue management for urology practices.
Correct Codes
In urology medical billing, you should start with putting the right codes according to the medical necessity. After checking the diagnosis from the medical prescription, put the relevant CPT and ICD-10 code in the patient data.
Claim Processing
Now, the claims submission step comes. Fill the claim with complete and accurate information about the patient. Add the right code and medical services provided by the hospital staff. Submit the claim before the deadline, otherwise, it will be rejected.
Denial Management
For example, your submitted claim got rejected because of some unseen errors. How will you manage it? You will submit this claim according to the new given guidelines. Spot the error that led to the rejection of the claim. Review the claim completely, make changes to it, and resubmit again.
Use Urology Billing Automation
You can use some AI-based and advanced urology billing tools in your practice. In this way, you can find errors in the claims and codes early. Further, automation will speed up your claim processing and reduce manual errors.
Choose the Right Urology Medical Billing Software| SysMD
Do you want to improve the efficiency and financial condition of your hospital? It is possible by choosing the right urology medical billing service provider like SysMD. It is a broad billing platform that you can outsource for your routine billing challenges.
Our urology medical billing experts are dedicated to improving revenues, reimbursements, and claim denials. We use electronic health records (EHRs) for all the services of patients. We use automated billing software to speed up the claim processing and other billing tasks. So, choose our urology billing services and get a chance to get paid faster.
Conclusion
In conclusion, you should understand urology billing practices to streamline your RCM. Outsourcing urology medical billing to experts ensures accurate coding, faster claims processing, and reduced denials. Your practice can boost revenue, cut administrative burden, and get paid faster with streamlined documentation, compliance, and advanced tools
Choose SysMD to enhance efficiency and financial performance in urology care.