Urology Coding Quickstart
Proven Formula to Get Urologists Paid Accurately For Every Service Provided
Part #1: What's Your Opportunity
Why Every Practice Needs a Urology Coding Plan
As a urologist, you are aware that providing excellent medical care to your patients is your top priority. However, you may not be aware of the opportunities your practice can reap by mastering coding and billing.
Coding and billing are the foundation of any successful medical practice. By accurately coding and billing for your services, you can maximize reimbursement, save time, and avoid the risk of audits resulting in take-backs. As a urologist, you have a unique opportunity to improve your practice's financial health by mastering coding and billing.
The problem is most practices don't know they have a problem.
In fact, every practice has a significant need for
documentation, coding and billing - compliance and education.
The average urology practice, whether the urologist has learned coding by attending a few seminars, listening to their coders, or has chosen to allow their staff, with a certified coder and knowledgeable biller, to do the coding, successfully collects on average about 80% of earned revenue. According to Medicare statistics for 2021, urology averaged a 17% denial rate. We can do better. You can do better.
We have proven that by increasing the understanding of the concepts, applying the rules, continuing education, and sharing up-to-date payer payment rules for both the urologist, the coding and billing staff, and the office, we can successfully collect the other 20% that is being left on the table.
How do you know if your practice has this problem?
Answer these 3 questions:
1) Do you know your level of knowledge and coding proficiency? What about the rest of the members of the Coding and Reimbursement team?
2) Do you know your denial rate and your contractual write-offs?
3) Does your team conduct routine audits to reevaluate services provided to determine if appropriate billing and collection resulted? Do you use outside audits to double-check "institutional knowledge"?
If you answered no to any of these questions, you are probably leaving 10% to 20% of your gross income on the table.
What does that mean exactly?
Lets do some quick Urology math using 10% and our 2022 averages:
- 50 hours - average worked per week
- $700,000 average urologist total reimbursement for all services
- $461,000 average urologist income
- 10% average loss revenue for practices that can’t answer yes to all 3 questions
If you recoup your 10% by proficient coding: learning, practicing, measuring, and continuing education, here is what these numbers would look like.
- 50 hours - average worked per week
- $770,000 average urologist total reimbursement for all services
- $531,000 average urologist income
- That is a 15% raise! (Instead of a 2% drop)
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