Urology Billing Services: Compare Companies, Fees, and Fit

Urology billing services manage claims and collections for urology practices. They send claims and chase what is unpaid. Coding and insurance approvals may be included or stay with your staff, depending on the contract.

We read the public pages of seven of them on October 5, 2026. Three put a number in writing. AdvancedMD lists a typical 4–8% range and describes its fee as a percentage of monthly collections. BellMedEx advertises "as low as 2.49%". MedCare MSO says most practices pay 4–8%, a general estimate rather than its own quote. The other four quote privately. We did not find a current monthly minimum amount on the specialty and pricing pages we reviewed.

The percentage is only half the price. If your practice buys drugs, gives them in the office, and bills for them, a fee on that drug money can matter more than the headline rate. In the Medicare example below, a 5% fee exceeds the amount collected above the assumed drug cost. So the first thing to ask is which money the percentage applies to.

On this page: what each company publishes, a fee check you can run with your own numbers, eight questions that show whether a company knows urology, and a request you can copy and send.

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Urology billing companies compared

Everything in this table is what each company says about itself on its own website. It is not proof of results. We did not test any of them. The list runs A to Z. It is not a ranking.

"Not described" means we did not find it on the pages we read. It does not mean the company can't do it. Ask them to put the answer in your proposal. See a detail that changed? Tell us.

A note on Medwave's urology page. On October 5, 2026, the page said a prostate biopsy "bills as 55700" and that ultrasound guidance may be billed separately. The American Urological Association's newsletter says code 55700 was deleted on January 1, 2026. This is about a web page. It does not show how Medwave bills real claims. Ask them question 1 below.

What the table tells you

• BellMedEx prints a specific starting rate. It is a floor ("as low as"), not a quote.
• We did not find a current monthly minimum amount on the pages reviewed. For a small practice, that number can decide the real cost.
• Keeping your EHR is different from keeping your billing system. Ask which systems remain, what moves, and what interfaces cost.
• "We handle prior authorizations" can mean different jobs. Some companies say they send the requests. PRS describes protocols and staff training. Get the submission and follow-up duties written down.
• Medwave explicitly says all money collected. Ask whether your written proposal excludes drug payments.

Go to a company

You contact the company yourself. We don't pass your details to anyone.

Which companies should you look at first?

These are starting points based on what each company publishes. They are not findings about who does the best work.

This page is mainly for independent practices and the people choosing their billing support. If a hospital or health system employs you, check who has authority to choose or change billing services before approaching companies.

What will a urology billing quote really cost?

It depends on four things: the percentage, which money it applies to, the monthly minimum, and the extra charges. Two quotes with the same percentage can differ by thousands of dollars a month.

Start with the drug money

A urology practice collects two kinds of money.

One is payment for your work: visits, cystoscopies, biopsies, surgeries.

The other is payment for drugs you bought and gave in the office. Examples include hormone-therapy injections such as leuprolide for advanced prostate cancer and BCG placed in the bladder for certain bladder cancers. That payment also has to cover what your practice paid to acquire the drug.

For most separately payable Part B drugs, Original Medicare sets the allowed amount at 106% of the drug's average sales price (ASP). A federal cut called sequestration then takes 2% off Medicare's share.

Here is a specific illustration: the drug uses that ASP-plus-6% formula, the deductible is met, Medicare owes 80%, and the normal 20% coinsurance is collected in full. Total receipts after sequestration are 104.304% of ASP. If the practice bought the drug at ASP, the amount collected above that assumed cost is about 4.13% of drug receipts, before billing and other costs.

Here is what that means. Say you collect $50,000 a month in drug payments under those assumptions.

• A 5% billing fee on that money is $2,500.
• The amount above the assumed drug cost is $2,063.20.
• The fee is $436.80 more than that amount. If receipts and the fee stay the same for 12 months, the fee on drug money alone is $30,000.

In this example, a fee above about 4.13% of drug payments exceeds the amount collected above the assumed acquisition cost. So ask every company: "Does your percentage apply to drug payments? If yes, at what rate?" Then get the answer written into the contract.

Our math: 106 × (0.80 × 0.98 + 0.20) = 104.304. Then 4.304 ÷ 104.304 = 4.1264%, rounded to 4.13%. This is an illustration, not a calculation of your drug profit. Actual purchase prices, uncollected coinsurance, other payer rates, and other Medicare drug formulas change the result. Some Part B drugs also have inflation-adjusted coinsurance, which changes the assumed 80/20 split. The drug examples above do not establish how any particular claim is paid.

A worked example: the lower percentage loses

These two quotes are made up. They are not any company's prices.

One month of payments: $100,000 for visits and procedures, including drug administration, $30,000 for drugs, and $10,000 collected on older unpaid claims. Total: $140,000. These groups do not overlap: older drug or service payments go in the older-claims group, not in both places.

Here, the minimum covers the combined fee on current visits, procedures, and drugs. Older-claims fees and other monthly charges are added afterward. The older-claims rate is the total rate on those payments, not an extra fee on top of regular billing.

Quote B has the higher headline rate, 6% against 5%. It still costs $900 less this month. Its $1,500 saving on drug fees more than offsets the $1,000 higher fee on visits and procedures. Lower fees on older claims and other monthly charges save another $400.

Now take a slow month: $40,000 for visits and procedures, $10,000 for drugs, nothing on older claims. Both minimums kick in. Quote A costs $4,300. Quote B costs $5,600. Now A is $1,300 cheaper.

That flip is why a new or small practice should check a slow month as well as a normal one.

Run your own numbers

The tool does fee math only. It can't tell you which company does better work. The calculator processes your entries in your browser and does not submit them to us or a billing company. Leave a fee blank if it is not confirmed; enter 0 only when the company confirms there is no charge. If a quote has different rates within one payment group or a minimum this tool cannot represent, send the proposal request and ask the company to itemize the same sample month.

Want to see how a minimum works on its own? See our monthly minimum example.

What should a urology billing service take off your desk?

"Full service" means different things at different companies. Go down this list and get a name next to each job: their team, your staff, or nobody yet.

If a job is "shared," split it into steps until each step has one owner.

Eight questions that show whether a company knows urology

Use these questions to check the team that would manage your urology account. Ask them on the sales call. Ask the person who would run your account, not only the salesperson.

A company doesn't need to ace all eight. But if the person who will run your account can't answer 1, 3, and 4, keep looking.

These are questions for choosing a company. They are not coding advice for a claim. Your coder and the insurer's own policy decide how a given claim is billed.

Why 2026 is a bad year to guess. Medicare changed how it pays doctors this year. Its 2026 rule applied a 2.5% efficiency reduction to assigned work values and intraservice time for affected non-time-based services, with exceptions. It also changed how indirect practice expenses within the physician fee are allocated between office and facility settings. Total payment changes vary by code and setting. The CMS summary of the final rule has the details. A billing company should be checking your payments against this year's amounts, not last year's.

What to settle before you sign

1. Get "collections" defined in writing. Insurance payments, patient payments, drug payments, refunds, and older claims each need a yes or no.
2. Get every charge. The minimum and what it covers. Setup. Software. Statements. Clearinghouse. Enrollment. Any charge for leaving.
3. Get the exit terms. How long the contract runs, how it renews, and how much notice you must give. "No long-term contract" still needs a notice period on paper.
4. Check the software. Ask them to show the work in your exact system. Ask what access they need and what must move.
5. Keep access to your data. Put report access, export formats, handoff fees, and the access period after termination in writing. Agree how records will be returned or retained; don't assume your login lasts forever.
6. Sign a business associate agreement first. An outside billing company handling protected patient information for a HIPAA-covered practice is a business associate. HHS publishes what that agreement should cover. Put it in place before sharing that information, including for an account review.
7. Compare like with like. Give two or three companies the same month of numbers and the same list of jobs.

If you are switching companies

1. Read your current contract's exit terms before you give notice.
2. List every open claim and appeal, every deadline coming up, and every payment not yet posted.
3. Agree on a start date, and on who finishes the claims from before that date.
4. Make sure you don't pay two companies on the same claim. Put the rule in both contracts.
5. After the first month, check the invoice against the jobs and the fee base you agreed to.

Copy this proposal request

Send the same request to each company. You will get answers you can compare. It has blanks for your details and no patient information.

Nothing is sent from this page. You paste it into your own email.

Choose a company to contact

Urology billing services: common questions

How long does it take to switch?

The companies give different answers. MedCare MSO says setup takes 5–7 days. PRS says it typically starts managing billing within 2–4 weeks. Those are the companies' own figures, not promised dates for your practice. Your old claims still need work during the handoff, so plan for some overlap.

Is outsourcing cheaper than billing in-house?

It depends on your collections, your staff costs, and what the fee applies to. Companies on this page claim savings, but those are their own numbers. Add up what billing costs you now in a year: pay, benefits, software, and clearinghouse. Compare that with a month-by-month forecast of outside fees, plus setup and the staff work you would still keep. Don't multiply a one-time setup charge or a temporary older-claims recovery month by 12.

Can I hire a company only for old unpaid claims?

Sometimes. Medwave publishes a dedicated A/R recovery offering. Ask whether it is available as a standalone engagement. Ask any company for a proposal that names the exact accounts, how old they are, and the fee. Don't assume your regular billing percentage covers this work.

Will a urology billing company raise my collections?

No one can promise that for your practice. The numbers on company websites are their own claims. They measure different things in different ways, so you can't line them up. Ask for references from urology practices your size, a sample report, and a plan for your specific problems.

I'm a patient with a urology bill. Can you help?

This page is for practices hiring a billing company. For your own bill, call the billing office on your statement first. Then call your insurer and ask for the explanation of benefits for that visit.

Ready to compare?

Pick the two or three companies that fit. Send each one the same request. Run the quotes through the fee check. Then compare the fee and the work your staff will still own.

Compare the 7 companies

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How we checked this page

We read each company's own website on October 5, 2026 and linked the page next to each fact. We picked companies that publish a page about urology billing, or sell billing together with urology software, and that say enough to describe the offer. We did not use these services, call the companies, or test their work. Billing rules come from Medicare (CMS), HHS, the American Urological Association, and AAPC, linked where they appear. The fee examples are our own math with made-up numbers. Read more about how we compare companies.