Urology is a complex area of the medical field featuring unique challenges in the healthcare revenue cycle management system as well. Urologists should opt for well-trained and experienced medical billing specialists who are well-versed in the nuances of urology billing services. A professional urology company that provides end-to-end urology billing and coding services can help providers achieve their revenue goals more easily & efficiently.
- Urology billing is a unique and challenging task that is well done by professional medical billers and coders.
- A professional urology billing company can assist healthcare providers to get back on the right track (focusing on patient care services) while they strive to collect reimbursements on behalf of the urology practice quicker and better.
- Urologists should follow a well-guided checklist to choose the best urology medical billing company for their practice.
What Is Urology?
Urology is a branch of medical sciences that deals with the diseases of the male and female urinary tract (that comprises kidneys, uterus, bladder, and urethra). It also includes the study of treatment and diagnosis of diseases of the male reproductive organs such penis, testes, scrotum, prostate, etc.
A urologist is a specialized surgeon who provides treatment for diseases of the kidneys, bladder, prostate, and male reproductive organs. This includes a wide range of diseases and a range of medical conditions, for example, cancer, kidney stones, infection, incontinence, sexual dysfunction, and pelvic floor problems.
As a urologist, you are familiar with the fact that in order to deliver satisfactory patient care services, it is essential to get full compensation for your hard-earned services, otherwise, you won’t be able to smoothly run your practice. It is only possible by managing the seamless functioning of medical billing and coding procedures.
Whether you hire an in-house team or outsource urology billing services, you have to be well aware of how the billing procedure works and what are the KPIs to measure the effectiveness of your urology billing solutions.
This is a quick guideline for the entire urology billing process, so stay tuned till the end;
Top Essential Steps Of Urology Billing Services
An end-to-end urology healthcare revenue cycle management starts right when the patient walks into your healthcare facility and keeps continuous until the healthcare provider doesn’t get reimbursement for their services whether the medical billing team has to follow up with the payers to send reminders or they have to manage and resubmit medical claims.
Here is the complete guideline to urology billing services;
Patient Registration
Patient registration is the most significant process of urology billing services. When the patient walks into the healthcare facility then the front desk staff collects patient’s demographic information including; patient’s name, phone number, insurance card, employment, residential address, and email (optional).
It is the responsibility of the patient registration staff to collect and verify the accuracy of the patient’s demographic information. If in any case, the patient has provided outdated information (such as residential address or phone number) then it can cause trouble down the line during the billing and coding process.
Recognize The Financial Responsibility
During patient registrations, the front desk staff must check out if the patient’s insurance company covers the following urology procedure. If the insurance company is not financially responsible for the urology diagnostic and medical treatment services then they must recognize the patient as the payer of these services.
It is a better idea to inform patients about their financial dues prior to delivering them healthcare services. In this way, they won’t find it hard to fulfil their financial responsibilities and feel encouraged to pay healthcare providers promptly.
Patient-Provider Encounter
When the patient completes the documentation procedure and finally meets the healthcare provider to get much-needed medical care services then it is called as patient-physician encounter or simply patient encounter.
It is the responsibility of the healthcare providers to fill out the encounter form during patient-encounter to record all the details about the services delieverd to the patient. This information is also recorded in patient electronic health records (EHRs0 along with their demographic information to create the medical history of the patient.
Medical Transcription
After filling out the encounter form, healthcare providers prepare a transcript from that information. Transcripts can be created with any reliable and well-encrypted voice recognition software.
Medical Coding & Charge Entry
Healthcare providers share their transcipts with the medical coding team who is responsible to collect, verify and convert the information from transcripts into standard medical codes.
Medical codes are the standard alpha-numeric nomenclature recognized universally used to prepare charge entry sheets and help healthcare providers to receive reimbursements from the insurance companies.
There are three types of medical codes;
- Current Procedural Terminology (CPT) Codes: introduced by the American Medical Association, CPT codes are used to report medical, surgical and treatment procedures to the insurance companies.
The Common Procedural Terminology (CPT) code range for urology services typically falls within the range of 50010-55899. This range includes various urological procedures and services such as diagnostic examinations, surgical procedures, endoscopic procedures, and other urological interventions. It’s important to note that specific procedures within urology may have their own unique CPT codes within this range, so it’s necessary to consult the current CPT code book or refer to reliable coding resources for accurate and up-to-date information on specific codes for urology services.
- International Classification of Diseases-Tenth Revision (ICD-10)
Introduced and managed by the World Health Organization (WHO), the internation classification of diseases (ICD) codes are used to describe the cause of death to the insurance companies and federal institutes. ICD codes are often modified and updated by the WHO as well.
The ICD-10 code rang for urology is from from N00 to N99. These codes cover various urological conditions and diseases, including those related to the kidneys, bladder, urethra, prostate, and other urinary organs.
Urology coding specialists apply these medical codes to prepare the charge entry sheet. This sheet contains all the information about patient’s demographics and patient-physician encounters in the form of standard medical codes.
Urology Medical Billing Services
It is the process of using a charge entry sheet to prepare billable medical claims. For this purpose, urology billing specialists have to comply with the billing requirements of the insurance companies and verify the accuracy of the information reported on the medical claim.
Also, urology billing specialists should deploy efficient solutions to submit medical claims to the insurance companies before their defined deadlines. If the medical billers fail to ensure the accuracy of medical claims then it end up being rejected or if the they don’t succeed to submit medical claims on time then they end up being denied.
It causes revenue loss and makes the urology practice to hit the bottom line too early.
Therefore, urologists should opt for professional and efficient medical billers who can streamline the billing and coding procedure and help you receieve your reimbursments seamlessly without any hassle of claim denials/rejections.
For example, CureCloudMD is a US-based urology billing company that provides a comprehensive suite of urology billing services which helps you improve your business functions and revenue growth.
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