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Urology Practice Management

We provide urology practice management services for groups at every stage. Independent practices, growing groups, and health systems building programs.

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Running a Urology Practice in a Tightening Market

The urology market looks different than it did five years ago. Reimbursement pressure keeps building. The workforce is aging out faster than residency programs can replace it. Groups that were thriving a decade ago now face questions they never expected to answer. SMCG works with urology organizations on the management and consulting questions that come with running a procedural specialty in this environment.

AUA census data shows forty percent of practicing urologists will reach retirement age within the next decade. Sixty-two percent of U.S. counties have no practicing urologist at all. The physicians who remain face Medicare conversion factor cuts, prior authorization burdens on imaging and procedures, and consolidation pressure from every direction. The groups that come through this period intact will be the ones that got serious about their business fundamentals before circumstances forced their hand.

Urology practice management and consulting services

Independent Urology Groups Weighing Their Options

Independent urology practices face a decision that didn't exist for the generation before them. Stay independent and figure out how to make the numbers work. Sell to a larger group or health system. Partner with a management organization that takes a piece of the revenue in exchange for back-office support. Each path has tradeoffs, and the right answer depends on what your group wants its future to look like.

The pressure isn't going away. Reimbursement continues to tighten. Administrative requirements keep expanding. The workforce shortage means fewer urologists available to share call coverage and absorb the overhead. Groups that don't address these pressures proactively eventually face them reactively, usually at worse terms.

We work with independent urology groups that want to understand their options before making a move. That starts with knowing where you stand: what your payer contracts are worth, whether your billing captures what it should, how your credentialing timelines compare to what they could be. The groups that stay independent do so because they run tight and they know their numbers.

Independence isn't free. It requires attention to the business side that employed urologists don't have to think about. It requires staying current on payer trends, reimbursement changes, and regulatory shifts that affect how urology practices get paid. Our marketing team helps independent urology groups build referral relationships and community visibility that support patient volume without relying on health system branding. For the groups that want to control their own future, independence is worth protecting.

Urology Medical Practice Performance

Urology medical practice performance comes down to whether the business side supports the clinical side or drags it down. A practice can have excellent physicians and still struggle if the billing lags, the payer contracts undervalue procedures, or the credentialing gaps keep new providers from seeing patients for months after they start.

We help urology groups identify where performance gaps exist and what it takes to close them. That might mean renegotiating contracts that haven't been touched in years. It might mean fixing a revenue cycle that leaks money through coding errors and missed charges. It might mean getting credentialing under control so adding a physician doesn't mean three months of lost revenue.

The goal is a practice that runs well enough to support whatever decision the partners want to make. Stay independent with confidence. Merge from a position of strength. Sell at a valuation that reflects what the practice is worth, not what a buyer thinks they can get away with. Performance gives you options.

Ancillary Revenue for Independent Urologic Groups

Urologic groups have revenue options that primary care practices don't. Imaging. Lab services. In some states, medication dispensing. These ancillary lines can make the difference between a practice that survives on thin margins and one that has room to invest in its future.

But ancillary services only pay off when they're run correctly. The compliance requirements are real. The startup costs need to pencil out against realistic volume projections. The billing has to capture the revenue without creating audit exposure. We help independent urologic groups evaluate whether ancillary services make sense for their situation and how to run them if they do.

For some groups, ancillary revenue is the difference between staying independent and being forced to sell. For others, it's a distraction from core clinical work that doesn't justify the investment. The answer depends on your patient volume, your payer mix, your geography, and your appetite for running additional business lines alongside clinical practice. We help groups think through these questions with real numbers, not assumptions.

Urological Groups Adding Physicians and Locations

Adding providers and opening new locations creates problems that single-site practices never face. The credentialing load multiplies. The billing gets more complicated. The payer contracts that worked for a smaller group may not make sense at the new scale. We work with urological groups in expansion mode on the management questions that come with getting bigger.

Expansion is supposed to improve the economics. More providers spreading fixed costs. More locations capturing patients closer to where they live. More leverage with payers because of larger volume. But expansion can also strain the back office past its breaking point if the infrastructure doesn't scale alongside the clinical side.

Urologic Credentialing for Multi-Location Groups

Every new location means a new round of facility credentialing. Every new provider means applications to every payer the group accepts. For urological groups adding multiple providers across multiple sites, the credentialing workload can overwhelm internal staff and create bottlenecks that delay revenue for months.

The timeline matters. A provider who starts work in January but can't bill until April represents three months of salary without offsetting revenue. Multiply that across several new hires and the cash flow impact becomes serious. Groups that expand without accounting for credentialing lead times often find themselves in a financial squeeze they didn't anticipate.

Our credentialing team works with multi-location urologic groups on managing the volume. We track applications, follow up with payers, and make sure new providers and new sites get through the process without the delays that eat into revenue during the onboarding period.

A new urologist who can't bill commercial payers for four months because credentialing stalled isn't generating the revenue the group projected when they made the hire. A new location that can't see Medicare patients because the facility enrollment lagged isn't serving the community it was supposed to serve. We help groups avoid these delays by treating credentialing as the revenue function it is, not the administrative afterthought it often becomes.

Urological Billing as Volume Increases

Billing that works fine at 8,000 encounters a year can break down at 20,000. The errors that didn't matter much when volume was lower start adding up. The denial rate that seemed acceptable becomes a serious revenue problem. The coding that captured most of what it should now misses enough to affect the bottom line.

Higher volume also means more payer interactions, more prior authorizations, more denials to appeal, more patient balances to collect. The administrative load scales faster than the clinical load because every encounter generates paperwork that multiplies through the revenue cycle. Groups that don't plan for this find their back office underwater while the clinical side keeps growing.

We help urological groups scale their revenue cycle alongside their clinical growth. That means identifying where the current process falls short, building workflows that handle higher volume without proportional staff increases, and making sure the billing operation keeps pace with the clinical side.

Urology billing carries complexity that general billing staff often miss. Procedural coding, modifier usage, bundling rules, site-of-service distinctions. A billing team that worked fine when the group had four providers may not have the depth to handle eight or twelve. We help groups figure out what their billing operation needs to look like at the next stage of growth and how to get there without losing revenue in the transition.

Health Systems Building Urology Programs

Health systems acquire or employ urologists expecting the service line to perform. When it doesn't, the questions land on leadership: why are the numbers below benchmark, why are the providers frustrated, why isn't the program growing the way the pro forma projected. We work with health systems on the management questions that determine whether a urology program succeeds or struggles.

Employed urologists work differently than independent ones. The incentives are different. The administrative support expectations are different. The tolerance for bureaucratic friction is different. Health systems that treat their urology program like any other service line often find themselves losing providers to private practice or competing systems that figured out what urologists need to stay productive and satisfied.

Building a urology program that works requires understanding what urologists value and what drives them away. It requires administrative infrastructure that supports procedural medicine rather than getting in its way. It requires compensation structures that make sense for the specialty and leadership that listens when providers flag problems before those problems become departures. Our operations and leadership team works with health systems on building urology programs that retain physicians and hit financial targets.

Practice Management for Top Urology Programs

The top urology programs inside health systems share certain characteristics. Their credentialing runs smoothly. Their billing captures procedural revenue accurately. Their providers spend time on clinical work rather than fighting administrative barriers. Their leadership understands what makes urology different from other specialties and manages accordingly.

These programs also tend to have administrative support that actually supports. Prior authorization staff who know urology procedures. Billing specialists who understand the coding. Credentialing coordinators who stay on top of renewals and new applications. The difference between a struggling urology program and a thriving one often comes down to whether the support infrastructure works for or against the physicians.

We help health systems build urology programs that perform. That means looking at the same fundamentals we address with independent groups, but accounting for the health system context: the internal politics, the shared services that may or may not serve urology well, the reporting structures that affect how quickly problems get solved. When the goal is a urology program that attracts and retains physicians while hitting financial targets, the details matter.

Some health systems inherit urology programs through acquisition and need help integrating them. Others build programs from scratch and need help avoiding the mistakes that plague new service lines. Others have struggling programs and need help diagnosing why. We work with health system leadership on whichever situation they're facing, bringing the same urology-specific perspective we bring to independent groups.

Schedule a Consultation

Talk with us about where your urology organization stands and what comes next. Whether you're an independent group weighing options, a multi-site practice managing expansion, or a health system building a urology program, we can help you think through the decisions ahead.

We've worked with urology groups since 2008. We understand the specialty. We know what questions to ask and what the answers mean. Start with a conversation about your situation and we'll tell you whether we can help.

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