Urology Billing Services From 5.0%: BPH, Stones, Biopsy

Who our urology billing service is for

We bill for independent urology practices from one urologist to 15 clinicians, including the advanced practice providers who run follow-ups and the injection clinic. The work spans office procedures, ASC cases and hospital days, often in the same week.

Hand your billing to us at one of these moments:

• Your biller left and stone, biopsy and BPH claims are aging while you hire.
• Denials on same-session scopes or injection lines keep coming back and nobody has time to appeal them.
• Your current billing company cannot tell you what is unpaid by site or by urologist.
• A new urologist starts next quarter and still has no payer enrollment.

What we take over and what your practice keeps

Our urology billing service runs every professional claim from the signed procedure note to the posted payment. The table shows where our work starts and what stays with you. We check every code against your clinician's documentation and never change a code without the clinician's sign-off. That review runs through our documentation-based code review.

Read the workflow as text

1. Map every site — Each urologist's office, ASC and hospital days set the place of service. Owner: Our billing team.
2. Turn notes into charges — Signed procedure notes become charges; missing notes are chased by name. Owner: Your urologists sign.
3. Verify drug and lab — Drug units, dose intervals and CLIA details confirmed before release. Owner: Our coding team.
4. Track authorizations — Authorization numbers and expiry dates logged for scheduled BPH, stone and biopsy cases. Owner: Our billing team.
5. Submit and post — Claims out within 1 business day of complete charge data; each line checked against expected payment. Owner: Our billing team.
6. Monthly KPI report — Office, ASC and hospital results on separate lines. Owner: Sent to you.

Where urology practices lose revenue, and what we do about it

Urology revenue leaks where one practice bills three settings plus drugs, lab work and biopsies. Each point names the failure, its source and our step.

Cases split across your office, ASCs and hospitals

• Wrong setting, wrong rate. We match the urologist's site schedule to the signed note before releasing office, ASC and hospital professional claims.
• Same-session scopes and stone cases. We compare units and laterality with the op note, post each line with its adjustment reason and investigate coding mismatches. 60-Day Underpayment Check: In month 3 we compare every payment from your first 60 days against your contracted rates and appeal each underpaid line. Needs your fee schedules.
• Urodynamics on hospital equipment. We check equipment ownership and the testing site before choosing the professional or global study claim.

In-office drugs, biopsies and lab work

• Hormone injections billed as routine shots. We reconcile the administered drug, dose, billing units and interval with the injection record before release.
• Prostate biopsy coding. We check the documented biopsy approach and imaging against the current code set and query a separate guidance line before billing.
• Urinalysis without the right certificate. We keep the CLIA certificate and analyzer details with your billing setup and check the test's required fields before release.

Bundling denials that still come back go through our denial management service.

What our urology billing costs

Urology practices pay the specialist physician group rate, set by size. Every urologist and advanced practice provider whose rendering NPI we bill counts toward your band. The percentage applies only to insurance payments, and we take 0% of copays and patient balances. Setup is $0. Invoices 1–3: only percentage fees on that month's insurance payments, plus any statements or add-ons you order. Percentage fees and mailed statements are capped at 9.0% of that month's insurance payments; from invoice 4, the $400 minimum applies even in a month when the cap comes to less. Your rate-card rate can't rise for 12 months from your start date; size-band changes still apply; later changes need 60 days' written notice.

Groups of 16 or more clinicians, or a urology group billing its own pathology lab, get the custom quote in the last row. See the full rate card and fee terms, or how billing companies price their work.

How we start: taking over from your biller or billing company

A billing switch puts your oldest stone, biopsy and BPH claims at risk first, so week one goes to deadlines. Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. Every inherited claim within 30 days of a filing, corrected-claim or appeal deadline is worked within 5 business days of access. Starts at access; covers up to 250 claims (more gets a day-1 deadline schedule); worked means submitted, corrected, appealed or returned with the fix.

What we need from your practice:

1. The signed service agreement and BAA.
2. Logins to your PM system and clearinghouse, plus read access to signed procedure notes in your EHR.
3. Your aging report at claim level, so near-deadline claims rank first on day one.
4. Every site where each urologist operates: office, ASCs and hospitals.
5. The in-office drugs you stock, with strengths, so units convert correctly.
6. Your CLIA certificate number and type, with your urinalysis analyzer models.
7. One kickoff call with your practice manager.

Our billing handoff plan lists the files to request from your outgoing biller. Want to see your deadline exposure first? Request The Free A/R Deadline Map: A claim-by-claim list of every unpaid insurance claim over 90 days in the aging report you send: payer, amount, the deadline it faces, the denial reason and the next action, sorted by deadline. Clock starts with your claim-level aging export and signed BAA; above 10 requests in a week, we confirm your date within 1 business day.

Monthly reporting, service standards and our guarantees

On-Our-Watch Guarantee. If a claim misses a filing, corrected-claim or appeal deadline while it is on our watch, we pay you what it would have paid. Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded.

Clock-or-Credit Guarantee. From go-live, every new claim goes out within 1 business day of complete charge data, and every denial is worked within 2 business days of posting — or $25 comes off your invoice for each late one. Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.

You can check each standard below against your own system's timestamps. Our monthly report states in writing how we define clean claims, A/R days and net collection rate, with office, ASC and hospital on separate lines. We publish client results only with written permission. Until we have them, judge us by the guarantees and the free Deadline Map.

Your systems, new urologists and patient data

We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. See the systems we work in. We sign a BAA before we see any patient data. Every payment goes straight to your practice's own bank account. We never receive, deposit or endorse your payments; we invoice you once a month.

Payer enrollment registers a new urologist with each payer so their claims can be paid. New-Clinician Enrollment: Clinicians who join while you're a client get enrollment filed with up to 5 payers each (the payer decides), with no per-payer fee. Beyond that, Credentialing & Payer Enrollment costs $149 per payer. Billed only after the payer confirms your effective date; $0 if denied or panel closed; filed within 5 business days of your complete packet.

Common questions

How much do your urology billing services cost?

Your rate depends on size: 6.0% for 1 clinician, 5.5% for 2–5 clinicians, 5.0% for 6–15 clinicians, of insurance payments. Patient payments carry 0%, and setup is $0. The rate card lists the minimum, cap and add-ons.

How should we choose a urology billing company?

Ask each company, in writing, how it bills cases split across office, ASC and hospital, how it counts injection drug units, what it charges and who pays for a missed deadline. Our answers are on this page, including two written guarantees. The billing company checklist sets out the contract terms worth comparing.

Are we locked into a contract if we hire you?

No. Month to month. Leave with 30 days' notice and no termination fee. Want a run-out? We keep working the claims we submitted for 90 days at your plan rate. Decline it and we charge nothing on payments that post after you leave. Notice by email; optional run-out covers claims we submitted before your exit date, at your plan rate; handover file within 10 business days of exit.

How fast can you take over our urology claims?

Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. What we need from you is listed under how we start.

Do you bill our ASC and hospital cases as well as office procedures?

Yes. We bill the professional claim for every case your urologists perform in the office, an ASC or a hospital, coded to the site where it happened. The ASC or hospital bills its own facility claim.

Can you handle in-office hormone injections and urinalysis claims?

Yes. We bill the drug and its administration together, convert milligrams to billing units and check each dose interval against your Medicare contractor's rules. Urinalysis lines go out under your CLIA certificate, so we need its number and type at kickoff.

Do you work in our EHR and practice-management system?

We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. See EHR and practice-management compatibility.

Can you credential and enroll a new urologist joining our group?

Yes. New-Clinician Enrollment covers urologists and advanced practice providers: Clinicians who join while you're a client get enrollment filed with up to 5 payers each (the payer decides), with no per-payer fee. Beyond that, Credentialing & Payer Enrollment costs $149 per payer. Billed only after the payer confirms your effective date; $0 if denied or panel closed; filed within 5 business days of your complete packet.