Specialized Urology Billing Services
Expert medical billing solutions designed for urology practices, optimizing revenue for prostate procedures, bladder surgeries, and urinary health treatments.
Comprehensive Billing Solutions for Urology Practices
Specialized Urological Coding
Expert handling of CPT and ICD-10 codes for prostate procedures, bladder surgeries, and urinary tract treatments.
Revenue Cycle Optimization
Maximize reimbursements for urology practices through fee schedule analysis, payer contract reviews, and strategic billing for urological procedures and tests.
Rapid Urological Claim Processing
Reduce days in accounts receivable with our fast, accurate claim submission and processing for urological procedures and diagnostics.
Denial Management for Urology
Proactively identify and resolve claim denials specific to urology, including prostate procedures and bladder surgery billing complexities.
Urology Billing Challenges We Solve
Complex Urological Procedure Coding
Urology involves intricate coding for procedures like prostatectomies, bladder surgeries, and ureteroscopies. We ensure accurate coding for maximum reimbursement.
Prostate Care Billing
We navigate the challenges of billing for prostate procedures, including PSA testing, biopsies, and treatments, ensuring proper documentation and payer compliance.
Payer Denials for Urinary Treatments
Urology claims often face denials for urinary tract treatments and advanced procedures. Our team implements strategies to reduce rejections and accelerate payments.
High-Volume Urological Tests
Urology practices often conduct frequent tests and procedures. Our team ensures each service is properly documented and billed to avoid missed revenue.
Benefits of Specialized Urology Billing
Faster, Cleaner Collections
Our urology billing expertise reduces denials and maximizes reimbursements for prostate procedures, bladder surgeries, and urinary treatments.
Regulatory Compliance Guarantee
Stay compliant with HIPAA and urology-specific regulations through our secure, audited billing processes for urinary health services.
Focus on Patient Care
By managing your billing, we allow your urology team to focus on delivering exceptional care to patients with urinary conditions.
Detailed Financial Reporting
Access comprehensive reports on collections, denial rates, and procedure volumes through our secure online portal.
Our Urology Billing Process
- 1
Urology Practice Assessment
We evaluate your current billing workflows for urological procedures, tests, and treatments, identifying opportunities for improvement.
- 2
Customized Billing Integration
Our team integrates with your EHR system and tailors billing processes for your urology practice’s specific needs, including prostate and bladder procedure billing.
- 3
Coding & Claim Submission
Expert coders handle complex urological coding for procedures and tests, submitting clean claims within 24 hours for faster reimbursement.
- 4
Payment Posting & Denial Resolution
We post payments, address denials immediately, and reconcile accounts to maximize collections for your urology practice.
- 5
Continuous Performance Monitoring
Receive regular reports on key metrics, denial trends, and revenue performance for urological services, with actionable recommendations.
Frequently Asked Questions
How do you handle billing for prostate procedures?
Can you manage billing for bladder surgeries?
How do you reduce claim denials for urology practices?
What reporting will I receive about my practice’s performance?
What causes most urology claim denials?
How long does it take to reduce urology accounts receivable?
What should we do with a CARC 18 duplicate claim denial?
Ready to Optimize Your Urology Billing?
Schedule a free consultation with our urology billing specialists and discover how we can boost your revenue for urinary health services.
Urology Billing Resources
Medical Billing Audit Checklist
A step-by-step checklist for auditing coding accuracy and documentation before claims go out the door.
Learn moreReducing Urology Claim Denials
Strategies to minimize rejections and optimize revenue for urological services and procedures.
Learn moreBilling for Urinary Tract Treatments
Navigate the complexities of billing for urinary tract treatments and prostate care in urology practices.
Learn moreAccounts Receivable
Reduce Urology Accounts Receivable: The 90-Day Plan
A practical sequence for bringing down aged A/R in a urology practice — aging triage, denial-pattern analysis, working the oldest recoverable claims, closing the coding and authorization gaps specific to urology, and the front-desk changes that stop new A/R from forming.
Phase 1 · Days 1–15
Inventory and triage the aging A/R
Start from a clean, claim-level picture of what is actually owed before touching anything.
- Pull a full A/R aging report by individual claim, not by summary bucket, segmented 0–30 / 31–60 / 61–90 / 91–120 / 120+.
- Separate insurance A/R from patient A/R, and separate true denials from claims that are simply unworked and sitting as "pending."
- Strip out anything already paid, adjusted, or written off so the number reflects only what is still recoverable.
- Flag any claim approaching a payer's timely-filing or appeal deadline and pull it forward regardless of its age bucket — those expire on a clock, not on priority.
- Assign a named owner and a target close date to every claim over 90 days old.
Phase 2 · Days 16–30
Diagnose payer mix and denial patterns
Find out why the money is stuck before working claims one at a time — the pattern tells you where to spend the next 60 days.
- Run a denial report by CARC/RARC code and by payer for the trailing 12 months.
- Rank denial reasons by dollar volume, not claim count — a low-volume, high-dollar reason (a missing prior authorization on a robotic prostatectomy) outweighs a high-volume, low-dollar one.
- Cross-reference denial reasons against payer mix: which payers make up the bulk of the aged A/R, and does each one deny for different reasons (Medicare Advantage prior-authorization denials read very differently than commercial bundling denials)?
- Identify the top recurring, fixable urology denial reasons and sort each into one of three buckets: front-end (eligibility, authorization), coding, or payer processing.
- Record a baseline — total aged A/R dollars, count of claims over 90 days, and denial counts by category — so the plan has something to measure against on day 90.
Phase 3 · Days 31–60
Work the oldest recoverable claims first
This is the bulk of the recovery work. Sequence matters more than volume.
- Work claims closest to a timely-filing or appeal deadline first, regardless of dollar amount — those go before anything else because they expire.
- Within that, sequence by dollar value: the highest-dollar recoverable claims at a given age before smaller ones of the same age.
- For each claim, confirm the original clean-claim submission, pull the EOB/ERA and denial code, correct the specific defect (missing modifier, wrong unit count, absent authorization number, address or demographic mismatch), and resubmit or appeal with the documentation that payer specifically requires.
- Route genuine write-offs — timely filing already missed, the provider was not enrolled with that payer at the time of service, the patient had no other coverage — to a separate write-off review instead of leaving them to sit as "still working" A/R.
- Check claim status before any resubmission. A second copy of a claim the payer is still processing denies as CARC 18, "Exact duplicate claim/service," and adds a denial instead of a payment.
- Track every reworked claim to a final outcome (paid, appealed again, or written off). A claim resubmitted three times with no resolution is a process problem, not progress.
Phase 4 · Days 61–75
Close the urology-specific coding and authorization gaps
Fix the upstream defects Phase 2 identified so the same denials stop generating new A/R while the old backlog is still being cleared.
- Build a payer-specific prior-authorization matrix for the procedures that generate urology's highest-dollar denials — robotic or laparoscopic prostatectomy, HoLEP, UroLift, Rezum, sacral neuromodulation (both the trial and the permanent implant stage), and ESWL — and confirm authorization is obtained and logged before the date of service.
- Audit E/M visits billed during a procedure's 10- or 90-day global period and confirm modifiers 24, 25, 57, or 79 are applied correctly and supported by documentation, instead of appealing bundling denials one at a time after the fact.
- Check NDC numbers, administered units, and wastage documentation on claims for testosterone, Lupron, Eligard, and other in-office injectables — an incorrect unit count is a recurring, fixable underpayment.
- Confirm claims for elevated PSA, hematuria, and BPH carry the specific ICD-10 code a payer's coverage policy requires (for example, BPH with versus without obstruction) rather than a default unspecified code that triggers a medical-necessity denial.
- Check that in-office lab and reflex urinalysis billing carries the correct distinct-service modifier when billed alongside an E/M visit or procedure on the same day.
- Confirm laterality on bilateral and one-sided procedures such as ureteroscopy and stent placement: some payers want modifier 50 on one line, others want RT and LT on two lines. Check which convention each payer uses.
- Hold procedure claims until the operative note is signed and attached. Missing notes are one of the two denials we see most across the practices we bill for.
- Feed every fix back into the practice's coding and documentation templates so the defect stops recurring.
Phase 5 · Days 76–90
Front-desk and eligibility changes that stop new A/R from forming
The recovery work is wasted if the same gaps keep creating new aged A/R behind it.
- Verify eligibility in real time at scheduling and again at check-in — coverage can change between when a procedure is scheduled and when it happens, especially for Medicare Advantage plans that re-contract networks annually.
- Capture and confirm secondary or supplemental coverage for Medicare patients at intake — a missed secondary is one of the more common sources of unbilled balances in a Medicare-age urology population.
- Move prior-authorization capture to the scheduling step for any procedure on the Phase 4 authorization matrix, and hold scheduling until the authorization number is on file.
- Flag self-pay and high-deductible patients at registration for a cost estimate and a collection attempt before the visit, rather than after the first statement cycle.
- Put a standing weekly aging review in place, using the same report built in Phase 1, so claims entering the 61–90 day bucket get worked before they become the next round of 90-day-old A/R.
Print-ready version
The same 90-day plan as a checklist you can work from directly, or forward to whoever owns billing at your practice.
Download the checklist (PDF)