Solutions
Plutus Health combines certified urology billing specialists with Olympus AI to improve coding accuracy, reduce denials, and optimize reimbursement across office, ASC, and hospital settings.
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GreenLight Laser, UroLift, Rezūm, TURP, and Aquablation each have unique CPT coding, documentation, and reimbursement rules that directly impact payment.
URS, ESWL, PCNL, stent placement, and laser lithotripsy all require precise procedure coding, modifier application, and documentation.
Prostate biopsy, cystectomy, nephrectomy, robotic procedures, and cancer therapies demand accurate coding supported by pathology, imaging, and operative reports.
Our certified coding teams understand American Urological Association guidance, payer policies, and specialty-specific reimbursement requirements.
Eligibility verification, prior authorization, CLIA validation, and LCD compliance reduce preventable denials before services are performed.
From coding and billing to denial management, underpayment recovery, AR follow-up, and reporting, every stage operates within a single workflow.
OlympusAI continuously reviews documentation, coding logic, payer edits, and billing workflows while certified specialists validate every high-value decision
Urology services include urologic procedures (TURP, lithotripsy, ureterscopy), imaging (ultrasound, cystography, urodynamics), medical management (BPH, incontinence), endoscopic procedures, male fertility services, and complex conditions requiring multi-visit management and specialized coding.
Challenges include proper endoscopic procedure code selection, bilateral procedure modifiers for kidney/ureteral services, imaging code accuracy, medical necessity documentation for procedures, treatment approach modifiers, unbundling vs bundling compliance, and payer-specific urology coverage policies.
Plutus Health maintains accuracy through urology-specialist certified coders, detailed operative/procedure report review, proper endoscopic code assignment, correct imaging code selection, bilateral modifier expertise, documentation sufficiency assessment, and regular urology specialty audits.
Critical compliance includes proper procedure documentation, medical necessity justification, bilateral procedure documentation (kidneys/ureters), imaging appropriateness, conservative vs surgical treatment documentation, post-operative follow-up coding, and adherence to payer-specific urology policies.
Urology practices using Plutus Health achieve clean claim rates of 97%+, denial rates below 5%, improved authorization accuracy, complete capture of all billable services, better compliance, and 98%+ contracted value collection through specialized urology expertise.
We diagnose your current state, baseline the leakage, and show you the to-be model.
The RCM Assessment is free. The findings are yours to keep, regardless of whether we work together.
Board-ready findings memo, quantified leakage estimate, transformation roadmap.