Urology Archives

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risk

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risk

sam-mi2013-07-11T09:00:16+00:00

Few things are more frustrating than providing care to a patient expecting fair payment in return, only to be informed that your Urology medical practice coding and billing claim is being denied because the payer doesn't think the service was medically necessary. You've ensured your revenue cycle management process is up to speed, or so you think. Yet, you're still faced with a good percentage of denied insurance claims. And it's beginning to affect your bottom line because your medical practice reimbursement is taking a hit. What's going on? While there are plenty of reasons an insurer might deny your claims, [...]

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risksam-mi2013-07-11T09:00:16+00:00

ICD-10 Conversion: Urology Revenue Cycle Management Expertise Makes the Difference

ICD-10 Conversion: Urology Revenue Cycle Management Expertise Makes the Difference

sam-mi2013-05-07T08:59:46+00:00

Do urologists and nephrologists actually catch a few breaks with the ICD-10 conversion? This transition might just streamline your work in some respects because ICD-10 codes are more straightforward in your specializations. You will see new combination codes for patients with co-morbidities like diabetes to which you will need to become accustomed. And where ICD-9 had two or three codes for a patient with diabetes and renal failure, there will be only one in ICD-10. There’s even more information out there that can help streamline your practice operations. But it takes special expertise in Urology revenue cycle management to not only [...]

ICD-10 Conversion: Urology Revenue Cycle Management Expertise Makes the Differencesam-mi2013-05-07T08:59:46+00:00

Unique Coding Fluctuations Require Unique Expertise in Urology Revenue Cycle Management

Unique Coding Fluctuations Require Unique Expertise in Urology Revenue Cycle Management

sam-mi2013-04-04T02:24:52+00:00

Urology coding is unique, especially with the continuous stream of industry changes and evolving compliance standards in urology revenue cycle management. Keeping up with all these changes is a 24/7 job by itself not to mention implementing all of them. You hate to admit it but some most likely fall through the cracks. Vigilance is key. Some coding changes that occurred in September 2012 related to avoidance of unbundling instillation, in/out catheter, and they bear repeating to ensure compliance and address those questions many urologists may still be pondering about coding for instillation based on the drug being used and charge [...]

Unique Coding Fluctuations Require Unique Expertise in Urology Revenue Cycle Managementsam-mi2013-04-04T02:24:52+00:00

Recent Chart Auditing Requirements Fuel Changes in Urology Revenue Cycle Management

Recent Chart Auditing Requirements Fuel Changes in Urology Revenue Cycle Management

sam-mi2012-12-26T23:25:15+00:00

What is the first step in maintaining a successful urology practice? Staying abreast of changing chart auditing regulations that directly impact the health of urology revenue cycle management. The quality of care provided by any urology practice is based on the accurate and complete clinical documentation of medical records. However, changes to the auditing standard have occurred to ensure that accuracy. Has your urology practice fully transitioned to SSAE 16? Developed in 2011 by the American Institute of Certified Public Accountants (AICPA), this new auditing standard replaces SAS 70 to keep pace with the growing acceptance of international accounting standards. The [...]

Recent Chart Auditing Requirements Fuel Changes in Urology Revenue Cycle Managementsam-mi2012-12-26T23:25:15+00:00

New Reimbursement Models Impact Urology Revenue Cycle Management

sam-mi2012-12-15T17:50:40+00:00

With new revenue reimbursement models forming as a result of the Affordable Care Act (ACA), Urology revenue cycle management is in a state of transition. In June 2012, the MGMA-ACMPE released the results of a questionnaire that ranked members' most pressing practice management challenges. No. 2 was: Preparing for revenue reimbursement models that place a greater share of financial risk on the practice. Within the next five years, urologists will be adopting this revenue reimbursement shared-risk model (vs. fee for service) with the emergence of population health management through Accountable Care Organizations (ACO). They coordinate care and meet performance standards of [...]

New Reimbursement Models Impact Urology Revenue Cycle Managementsam-mi2012-12-15T17:50:40+00:00

Prepare Now to Mitigate Potential Compliance Risks in Urology Revenue Cycle Management During 2013

Prepare Now to Mitigate Potential Compliance Risks in Urology Revenue Cycle Management During 2013

sam-mi2012-11-16T16:47:11+00:00

The Office of Inspector General (OIG) Work Plan for 2013 was released in October. Are you ready to implement the myriad of updates about potential risks in your Urology coding, billing and collections? Was that a faint "yes" or a resounding one? With the New Year fast approaching, the time is now to make sure your practice is fully prepared and your compliance plan is up to date. It is helpful for your compliance plan to include answers to the following questions: What is the OIG Work Plan process? What compliance areas should your practice address? What issues will be investigated [...]

Prepare Now to Mitigate Potential Compliance Risks in Urology Revenue Cycle Management During 2013sam-mi2012-11-16T16:47:11+00:00