Drug and procedure claims need their own queue
Injectable therapies and in-office procedures carry higher dollar values than a routine visit, so a denied claim costs more and takes longer to recover. Treating them as part of the general claim stream slows them down.
We keep a separate queue with explicit checks: authorization, units, diagnosis linkage, and documentation of administration.
- Injectable drug authorization and unit calculation
- Cystoscopy and in-office procedure coding
- Imaging and diagnostic study billing
- Urodynamic and diagnostic testing requirements
Recurring visits, recurring balances
Urology patients often return frequently for monitoring, which makes patient balances accumulate quietly. Reporting them by patient rather than by claim shows where a conversation is needed.
We also track authorization expirations, since ongoing therapy plans frequently outlast an approval.