3 Mistakes to Avoid in Urgent Care Billing

Mistakes in urgent care billing, most often, prove to be expensive. In other words, it’s not a matter of losing just a few cents or a handful of dollars at the most. Billing mistakes can lead to sizeable claims getting denied or rejected, and will make collections take a bad hit. If the mistakes are not rectified at the earliest opportunity, the losses can add up quickly and make a serious dent in overall profitability. So here are 3 of the worst mistakes that most urgent care centers make. Do I have your attention?

Mistake #1
Absence of a proper contract

This refers to entering into a formal contract with a payor to have an urgent care center included in the payor’s list of in-network centers. This is a crucial step for ensuring that an urgent care, after providing some service to a patient, can bill the concerned insurance company in order to get compensated. Entering into contracts with various payors, therefore, constitutes one of the very important initial steps for any urgent care center planning to start operations. In the absence of a proper contract, the billing party may have to settle for a low reimbursement or, at other times, no payout at all.

Mistake #2
Skipping credentialing

Most people tend to confuse credentialing with contracting, using both the terms interchangeably. The truth is, both refer to two very different kinds of processes. Credentialing essentially refers to the payor’s process of ensuring a provider’s ability and credibility to render the services that it purports to provide. In other words, it is a process of verifying the provider’s experience, expertise and qualifications to ensure the safety of patients. What needs to be borne in mind in this respect is that credentialing requirements vary from payor to payor. So if you find that one payor does not require credentialing, it would be foolish to assume that the next payor will follow the same rules. Whatever be the nature of the requirement, no urgent care center can afford to neglect it because it is closely linked to getting reimbursed eventually by the payors.

Mistake #3
Failing to capture patient data at the front desk

Well begun is half done, they say. And nothing could be closer to the truth, especially when it comes to urgent care billing. The moment a patient – a new patient or a returning one – walks into an urgent care center, the front desk should collect all essential information in order to facilitate the billing afterwards. Doing a botched job at the front desk could mean not just missing out on copays, but also running the risk of getting claims rejected due to inadequate or inaccurate patient information. It is important to remember that trying to collect patient information later, almost always, unnecessarily lengthens the billing process. One is also likely to find patients hard to reach, and even somewhat uncooperative in providing the required information, after they have left the urgent care center.

The solution

These are just 3 of the many other pitfalls that urgent care billing frequently suffers from. There’s a lot to keep in mind, and one false move or missed step can prove to be costly. This is why, a large number of urgent care centers opt to outsource their billing to professional, dedicated third-party billing facilities. Not only does it reduce denials and improve overall collections, but it also brings down operational expenses substantially. So if you are running an urgent care center and are facing billing problems, it is time you gave outsourcing your billing operations a serious thought.