Prevent
Urology Denials
AI revenue cycle automation built for urology practices — specialty-aware coding, prior auth, and denial appeals that protect your procedure, drug, and in-office revenue.
55%+
denials prevented
98%
coding accuracy
3 days
to onboard
Trusted by Industry Leaders
Why urology claims get denied
Urology blends in-office procedures, expensive buy-and-bill drugs, and surgery — each with its own payer rules. Most denied and underpaid claims trace back to a handful of recurring coding gaps.
Cystoscopy and procedure bundling
When cystoscopy is performed with stone removal, biopsy, or stent placement, bundling and modifier rules decide what's separately payable. Missing the right modifier collapses distinct services into a single underpayment.
Global-period and modifier errors
TURP, lithotripsy, and other surgeries carry global periods plus staged, bilateral, and unrelated-visit rules. A missing modifier 24, 25, 58, or 79 turns post-op and related care into denials.
High-cost drugs billed wrong
Buy-and-bill agents like leuprolide (Lupron) and intravesical BCG carry expensive J-codes, units, and wastage rules. A mis-keyed unit or missing documentation leaves significant drug revenue uncollected.
Prior auth stalls procedures and drugs
Advanced imaging, androgen-deprivation therapy, and many procedures require pre-auth. Manual auth chasing delays treatment and a missing or expired authorization denies high-value claims outright.
Ancillary testing and medical necessity
Urodynamics, PSA, and imaging carry frequency limits and medical-necessity criteria. Without documentation that meets payer policy, recurring testing denials erode in-office revenue.
Coding rules and trends keep moving
Urology coding shifts every year, and keeping every coder current is a constant battle. The 2026 prostate-biopsy overhaul is a prime example — 55700 gave way to a granular family (55705-55715) that bundles imaging by approach and guidance. Practices that don't track these rule and trend changes lose revenue to rejections and missed opportunities.
Works with EHR & PMS
What Ember automates for urology
Cystoscopy bundling and modifier scrubbing
Ember applies bundling edits and modifiers when cystoscopy is paired with stone removal, biopsy, or stent placement — so separately payable services are paid distinctly instead of collapsed into an underpayment.
Global-period tracking, built in
Ember knows the global window on TURP, lithotripsy, and other surgeries and flags post-op, staged, and unrelated services that need modifier 24, 25, 58, or 79 — stopping bundling denials before claims go out.
Buy-and-bill drug units and wastage, captured
Ember keeps J-codes, units, and documented wastage accurate on leuprolide, BCG, and other buy-and-bill agents, and confirms auth is in place — so expensive drug claims are paid in full.
Prior authorization, handled
Ember checks eligibility, identifies which imaging, drugs, and procedures need pre-auth, gathers documentation from the EHR, and submits through payer portals — so treatment doesn't stall on missing authorizations.
Ancillary-testing medical necessity
Ember validates urodynamics, PSA, and imaging against payer frequency limits and medical-necessity criteria before submission — preventing the recurring testing denials that erode in-office revenue.
Always on top of the latest rules and trends
Ember stays current with evolving coding rules, payer policies, and billing trends — so your team doesn't have to. When updates land like the 2026 prostate-biopsy overhaul (55700 to the new 55705-55715 family), Ember applies the right codes, approach, and bundled imaging automatically — keeping claims clean as the rules change.
Outcomes urology teams can measure
55%+
of denials prevented before submission
98%
autonomous coding accuracy
50–75%
fewer staff hours on denial workflows
3 days
to onboard — value, not a year-long rollout
Based on Ember AI benchmarks across customer practices. Results vary by payer mix and specialty.
As Seen In
Frequently Asked Questions
Yes. Ember AI connects seamlessly with all major EHRs and PMS platforms — including Epic, Oracle Cerner, athenahealth, and eClinicalWorks — as well as payer portals. Our standards-based integrations automate prior authorization, eligibility verification, and claims submission, allowing you to preserve existing infrastructure while modernizing the revenue cycle.
Ember AI deployments are measured in weeks, not months. Most organizations complete pilot launch in under 30 days and scale enterprise-wide within a quarter. We provide a structured onboarding playbook, technical support, and change-management guidance so your teams achieve measurable ROI rapidly with minimal IT lift.
Yes. Ember AI is fully HIPAA and SOC 2 Type II compliant and signs Business Associate Agreements (BAAs) with all covered entities. Protected Health Information (PHI) is encrypted in transit and at rest, supported by role-based access controls, detailed audit logging, and continuous monitoring. Your organization retains complete ownership and control of its data.
Health systems, MSOs, and health plans using Ember AI typically achieve:
- 50-75% reduction in FTE hours
- Faster cash acceleration
- Prevent 55%+ of denials
We provide ROI benchmarks and dashboards so you can track outcomes from day one.
- 50-75% reduction in FTE hours
- Faster cash acceleration
- Prevent 55%+ of denials
We provide ROI benchmarks and dashboards so you can track outcomes from day one.
Yes. Ember's coding and scrubbing logic is specialty-aware — it understands cystoscopy and endoscopic procedures, surgical bundling and global periods, buy-and-bill drugs, and ancillary testing, and validates documentation against payer medical-necessity criteria before submission.
Ember applies the right bundling edits and modifiers when cystoscopy is performed with stone removal, biopsy, or stent placement — so separately payable services are paid distinctly instead of collapsed into a single underpayment.
Yes. Ember keeps J-codes, units, and documented wastage accurate on leuprolide, intravesical BCG, and other buy-and-bill agents, and confirms prior authorization is in place — so expensive drug claims are paid in full.
Yes. Ember checks eligibility, identifies which imaging, androgen-deprivation therapy, and procedures require pre-auth, gathers the needed documentation from your EHR, and submits through payer portals — reducing the delays and missing-auth denials that hit high-value urology claims.
Ember connects to your existing EHR/PMS and payer systems with standards-based integrations — no rip-and-replace. Most teams pilot in days and see measurable ROI before scaling across service lines.
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