In today’s healthcare environment, urology revenue cycle management (RCM) must go beyond chasing claims and keeping files up-to-date. By modernizing how you approach revenue cycle management for your urology practice, you can use RCM to drive growth and promote resilience.
Whether your organization is a one-physician urology practice or a multi-location group, inefficiencies in billing, claims management, and contract management can erode your bottom line. And with rising costs, regulatory pressures, and increasingly complex payer contracts, outdated processes simply won’t cut it.
We’ll help you rethink the way you approach urology revenue cycle management, covering what challenges you are up against and how to overcome them with new technologies.
Urology involves a mix of surgical, diagnostic, and office-based procedures. Each of these interventions comes with its own documentation and coding requirements. This complex system can introduce billing vulnerabilities and increase the risk of claim denials.
Effective urology revenue cycle management supports:
Without a well-structured RCM system, your practice will deal with longer reimbursement timelines and increased manual work. This leads to uncertainty around net revenue.
When it comes to revenue cycle management, urology practices face the following hurdles.
Urology services are reimbursed under highly specific guidelines that vary by insurer. Managing rate sheets manually or using fragmented systems makes it hard to ensure you’re getting paid accurately and even harder to identify underpayments.
Revenue cycle management acronyms only add to the complexity, as do varying payer trends regarding similar procedures. If you don’t have good visibility into payer contract performance — or even into the conditions you are operating under — you’ll be at a huge disadvantage come negotiation time.
Urology revenue cycle management involves nuanced coding and procedural billing. As a result, even small errors can lead to claim denials. Common issues include:
Over time, these problems become revenue leaks that erode your profit margins. Identifying the root cause of claim denials allows you to plug the leaks and recapture lost revenue.
Procedures like cystoscopies, lithotripsy, and prostate biopsies require expert coding knowledge. Errors here disrupt urology revenue cycle management and force you to invest heavily in reworking claims.
Improving your billing and coding accuracy begins with establishing a clear, unified view of your revenue cycle. A lack of visibility means billing errors go undetected for far too long, if not indefinitely.
View our on-demand webinar to learn more about the metrics you should be watching to track and improve your RCM urology billing and coding practices.
Many urology practices struggle with upfront patient collections, leading to cash flow issues and collection delays. Effective urology revenue cycle management must include transparent estimates and proactive communication with your patients.
No one likes to receive surprise bills, especially if they have already paid up front. Your patients expect accurate estimates so they know their out-of-pocket obligations before receiving treatment.
Download our ebook to learn more about the basics of patient revenue cycle management for urology practices, including how patient collections fits into your strategy.
To remain profitable and efficient, your urology practice should consider these best practices.
If billing accuracy and coding mistakes are recurring issues in your practice, the root cause could be poor training or outdated technology.
First, evaluate your team’s competency in urology-specific coding and close any gaps by investing in targeted training. Then, equip them with billing technology that proficiently handles urology’s CPT codes and documentation requirements.
Even incremental improvements to your coding accuracy will result in downstream denial prevention. You can then reroute your resources to addressing less common types of denials and recapturing revenue before it's lost for good.
Full visibility into payer performance helps you identify patterns of underpayment, delayed reimbursement, or systemic issues. You need to know which payers are failing to honor their contracts and where they are falling short. Use these insights to prepare for contract negotiations and fight for better terms that benefit your practice.
Payers are accustomed to having the upper hand in contract negotiations. Urology revenue cycle management data levels the playing field.
Are you still manually tracking and resubmitting denied claims? This old-school approach simply isn’t efficient enough in the modern healthcare setting.
Automated tools will help you track and classify claims submission and denial management processes. Cutting-edge tools can identify which denials should take priority so that your team can recapture more revenue.
Automation also sets the stage for healthcare revenue forecasting, allowing you to predict future cash flow and seize opportunities as they emerge.
Offering patients real-time estimates and multiple payment options is nonnegotiable. A frictionless billing process increases upfront collections and boosts patient satisfaction. Improving communication and upskilling your staff are two more ways to promote better collections processes.
Not sure where to start with your training efforts? Conduct a revenue cycle audit and open up communications with your team. Brainstorm ideas for making targeted improvements that will help you build momentum quickly before turning your attention to longer-term initiatives.
Rivet is redefining revenue cycle management for urology practices with a streamlined suite of tools designed to give you better clarity, control, and cash flow. Here’s how Rivet helps:
Are you ready to explore our healthcare revenue cycle management solutions? Schedule a demo with Rivet to see how our RCM solutions can transform your practice.
