Urology Billing Services for California Hospitals and Clinics
Medi-Cal managed care, Knox-Keene’s 30-day payment rule, and workers’ compensation utilization review each carry separate deadlines. Missing one can delay reimbursement or forfeit it entirely. Transcure aligns coding, authorization, and appeals with all three. What that looks like in practice:
- Coders track L.A. Care, IEHP, and CalOptima prior authorization rules directly.
- PRIA and CODIN automate eligibility checks, authorizations, and appeals instantly.
- Workers’ comp denials route through DWC review before deadlines close.
- Dedicated team handles Anthem Blue Cross, Blue Shield prior auth.
- ARIA flags claims nearing Medi-Cal’s one-year Welfare Code 14115 deadline.
- Appeal every denial instead of filing it away, keeping first-pass clean claims up to 98%.
Our Success in Numbers
Results vary by practice size, specialty and payer mix. Across Transcure clients, these are typical results:
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
The Regulations Behind Every California Urology Claim
Compliance is not a checklist item here. It shapes how each claim gets built. At Transcure, we align our billing with California billing laws.
AB 3275 and the 30-Day Payment Rule
Since January 1, 2026, DMHC-regulated plans must pay complete claims within 30 calendar days, per Health and Safety Code 1371(a)(4), 1371.35(b), and APL 25-007. Late payments accrue 15 percent annual interest, plus a $15 or 10 percent penalty if undisclosed. We bill that interest.
Commercial Insurers Under Insurance Code 10123.13
Insurers follow the same 30-calendar-day clock, 15 percent interest, and $15 minimum penalty for undisclosed interest as DMHC plans. We apply this claim by claim to Anthem Blue Cross and Blue Shield of California urology submissions, catching every missed deadline.
Medi-Cal's Faster, Stricter Standard
DHCS APL 23-020 requires Medi-Cal MCPs to pay 90 percent of clean claims within 30 days and 99 percent within 90 days, a volume standard we use as leverage. The filing deadline is one year from the service date under Welfare and Institutions Code 14115.
Workers' Compensation Timelines
Bladder and kidney trauma from workplace injuries follow Labor Code 4603.2(b): payment due within 45 working days, submission within 12 months, extendable to 5 years for cumulative trauma without prior authorization. These claims route through DWC's utilization review and independent medical review, separate from commercial appeals.
What Urology Billing Services Does Transcure Provide in California?
Transcure’s urology billing services span the full revenue cycle, from eligibility checks through final collections, purpose-built for California urology practices and their payer mix.
Urology Billing Services Across California Cities
Transcure delivers urology billing services across California’s largest cities. We are adapting to regional payer networks, hospital referral systems, and Medi-Cal managed care rules unique to each market.
Los Angeles, California
San Diego, California
San Jose, California
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San Fransisco, California
Fresno, California
Sacramento, California
Long Beach, California
Bakersfield, California
Oakland, California
What Has Changed in Urology Billing for 2026?
CPT 55700, the prostate needle biopsy code covering any approach, was deleted January 1, 2026, and replaced by nine codes (55707 through 55715) plus a revised 55705 for non-image-guided biopsy. Selection now depends on approach (transrectal, transperineal, in-bore), guidance method (ultrasound, MRI-fusion, in-bore CT or MRI), and whether the biopsy is systematic or targeted by lesion.
CPT 76872 and 76942 can no longer be billed separately alongside any prostate biopsy code, since imaging guidance is bundled into the new family. Aquablation moved from Category III code 0421T to Category I code 52597. CPT 52443 now covers cystourethroscopy with transurethral anterior prostate commissurotomy using a drug-coated balloon catheter.
Practices still billing 55700, 76872, or 0421T on 2026 claims face immediate invalid-code rejections. Transcure keeps your urology billing current with every CPT update, so your claims stay clean, compliant, and reimbursed without delay.
Counties Served by Transcure's Urology Billing Services in California
Transcure provides urology billing services across California counties, coordinating with the region’s dominant Medi-Cal managed care plan in each market.
Los Angeles County
San Diego County
Orange County
Riverside County
San Bernardino County
Santa Clara County
Common Urology Procedures Covered by Transcure's Billing Services
Transcure handles billing for the full range of urology procedures California practices perform daily, ensuring accurate coding, clean claims, and faster reimbursement across every payer type.
Cystoscopy Billing
We apply CPT 52000 for diagnostic cystoscopy and CPT 52204 when a biopsy is performed, since the biopsy code includes the scope. AUA/SUFU microhematuria risk tier documentation is verified upfront to prevent denials for insufficient indication.
Vasectomy Billing
Get CPT 55250 billed with accurate global period tracking, confirming payer-specific coverage rules and consent documentation. Proper handling of the 90-day global period avoids underpayment and improper unbundling that triggers payer audits.
Ureteroscopy Billing
We code ureteroscopy claims by approach under CPT 52351 through 52356, covering diagnostic, stone extraction, and laser lithotripsy cases. Documentation is matched to the correct code, with LT or RT modifiers applied for laterality.
Shockwave Lithotripsy
Our team applies CPT 50590 with detailed stone size and location documentation to support medical necessity. This proactive approach prevents payer pushback on indication and secures timely, accurate reimbursement for lithotripsy procedures.
TURP Billing
We code TURP under CPT 52601, tracking payer-specific edits and bundled services, including postoperative bleeding control. Careful attention to bundling rules avoids the denials that commonly follow transurethral resection procedure claims.
Prostate Biopsy Billing
With the 2026 coding overhaul, we assign the correct code from the 55705 to 55715 family based on approach and imaging guidance. This keeps claims compliant with the new structure and prevents instant rejections.
Our Certifications
Transcure medical billing services operates under strict HIPAA compliance to protect patient data. Along with AAPC-certified coders ensuring accurate CPT and ICD-10 usage, and SOC-certified systems safeguarding your urology practice’s billing infrastructure and information security.
Why California Practices Choose Transcure For Urology Billing?
California urology practices trust Transcure for accurate coding, faster reimbursements, and fewer denials. Our team understands the state’s payer rules inside and out, so your revenue keeps moving without unnecessary delays or disruptions.
In-House Coders & Billers
Certified urology coders and billers handle your claims directly under our roof, not outsourced overseas. This means tighter quality control, faster fixes, and coding accuracy that protects every dollar you’ve earned.
Dedicated Specialty Manager
You get a single point of contact who knows urology billing and your practice’s specific workflow. No repeating your issue to a new rep every time. Just one manager who tracks your account closely.
24/7 Billing Support
Questions don’t wait for business hours, so neither do we. Your team can reach billing support around the clock, meaning issues get resolved fast, and your cash flow never stalls waiting on a callback.
Faster Turnaround Time
We know delayed claims mean delayed revenue. Our streamlined submission process gets your claims out the door quickly and tracks them closely, so you see reimbursements land in your account sooner, not later.
Practices Compliance
Your practice stays protected with billing that follows California and federal regulations to the letter. We monitor payer policy changes constantly, allowing you to avoid audits, penalties, and compliance headaches down the road.
How Transcure Improved Idaho Kidney Institute’s Claim Recovery by 66%
Idaho Kidney Institute faced a $300,000 backlog of unpaid claims stuck in the 60+ day bucket. Partnering with Transcure, IKI reduced that backlog to $100,000 within 90 days, a 66 percent improvement, by resolving denied claims, insurance verification gaps, medical necessity issues, and coding errors, freeing staff to focus on patient care instead of billing.
Which EHR Platforms Do Our Urology Billing Services Support?
We work with Athenahealth, NextGen, and other major EHR software directly, keeping clinical documentation and claims data in sync.
Trusted by Urology Service Providers In New York
Transcure billing company provides professional billing services across 40+ specialties, and that’s why we have a good reputation on major review platforms.
What Clients Say About Our Medical Billing Services
California practices trust Transcure to simplify billing, reduce denials, and speed reimbursement.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions About Urology Billing Services in California
What happened to CPT 55700 for prostate biopsy billing in California?
CPT 55700 was deleted January 1, 2026. Transcure assigns the correct replacement code from the 55705 through 55715 family based on approach and imaging guidance, preventing invalid-code rejections on every California urology claim.
How fast must California health plans pay a urology claim under AB 3275?
DMHC-regulated plans must pay complete claims within 30 calendar days starting January 1, 2026. Late payments accrue 15 percent annual interest, which Transcure tracks and collects on behalf of California urology practices.
Which California counties does Transcure serve for urology billing?
Transcure bills across Los Angeles, San Diego, Orange, Riverside, San Bernardino, Santa Clara, Alameda, Sacramento, Fresno, and Contra Costa counties, coordinating claims with each county’s dominant Medi-Cal managed care plan directly.
How does Transcure reduce Medi-Cal Managed Care denials for urology practices?
Certified coders track DHCS APL 23-020’s 30-day clean claim standard and apply each MCO’s own prior authorization rules for BPH, PSA, and urodynamic studies before submission, catching issues before payers do.
What happens to workers' compensation claims for urology trauma injuries in California?
Bladder and kidney trauma claims follow Labor Code 4603.2(b), requiring payment within 45 working days. Transcure routes unpaid bills through DWC utilization review and independent medical review before filing deadlines close.
Which EHR platforms integrate with Transcure's California urology billing services?
Transcure integrates directly with Athenahealth, NextGen, and other major EHR platforms, keeping clinical documentation and claims data synchronized. So, California urology practices avoid manual entry errors and submission delays.
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