Urology medical billing and coding is a precise work undertaking which should be handled by a team of professionals. If a urology facility fails to meet required regulations by all the concerned parties, you might face a negative income cycle.
If you look at the history of urology medical billing and coding, one can rectify a certain pattern of Do’s and Don’ts. This not only keeps the coders attentive in their work, but also ensures that maximum clean claims are submitted.
Here are the Do’s and Don’ts for urology billing and coding:
Ensure Patient Information
As with the claims submission, patient verification information is critical for your reimbursement. Ensure to get the patient’s insurance data, verification such as date of birth and Social Security number, along with home address for demography purpose, and any special notes from the doctor after the visit. Precise information of the patient will allow for urology claims to get approved faster and reimbursed quicker.
Confirm Provider Information
After ensuring the patient information, it’s vital to verify that information as well. When filing urology claim, make sure to provide your urology facilities correct address and contact information, along with the identification numbers and the EDI processing numbers.
Using a Clearinghouse
To increase the medical billing and coding efficiency avoid errors within the claims processing, use the services of a clearinghouse. A resourceful clearinghouse will check your urology claims to ensure that each claim is free of error before final submission. Even if an error is found, the clearinghouse alerts the billing professional for a quick fix. This way it lessens the headache down the road for inaccurately filed or coded claims.
Resubmitting error free denied claims
If a urology claim has been denied, there must have been a good reason for that. Verify that the claim is error free before your tm submits it’s automatically. If the in-house team has put incorrect diagnosis codes then rectify the mistake and submit again. Check with the attending urologist as to what diagnosis codes should be assigned within the claim and then proceed with the with resubmission process.
Under some specific insurance coverage provisions visits are not able to be submitted for claims twice. Remember that Medicare has very clear guidelines about billing and coding for postoperative visits.
Forgetting the Clearinghouse
As said in the Do’s section as well, the purpose of a clearinghouse is to make sure that each urology claim submitted is error free. A properly designed and defined clearinghouse identifies errors, eliminating the risk claim denial. If you don’t have a clearinghouse, chances of you submitting a clear claim shrinks. Always remember that submission and re submission takes extra time and resources that leads to a deficit in both time and money of your urology practice.