The 5-Minute Primer on Urgent Care Billing You Need to Read

Medical billing is an area that is often rife with confusion. It is a complicated process, comprising many smaller milestones that together make up the entire journey, starting from the moment a patient walks into a provider’s place, and ending in the final payment received from the Health Plan (or from the patient, if he or she is not insured). The same applies to Urgent Care billing, only in a faster manner. Let me explain.

Urgent Care facilities have to work on an expedited speed. The very reason they exist is to provide immediate medical attention to whoever may need it. The waiting time is low and the front-desk often has to act quickly to collect all requisite patient data so that a proper bill can be drawn up later on. If important details are missed at this point, it may get very difficult to collect them afterwards, especially after the patient has walked out the facility.

All Urgent Care centers have tie-ups with commercial as well as government insurance plans. These may typically include Aetna, BCBS, Cigna, Humana, First Health, Galaxy Health Network, PacifiCare, United Healthcare and other commercial insurers on one hand and Medicaid, Medicare, Right Care Health Plan, TRICARE and other government plans on the other.

In a typical scenario, the patient, if he or she is covered by insurance, should carry the insurance card to facilitate the registration process and make the entire Urgent Care billing process faster. This can significantly reduce the waiting time to receive the desired treatment. The front-desk staff copies the details on the card and submits charges directly to the appropriate insurance company. Any applicable copays are usually collected at the time of service. About 3-4 weeks after the visit, the patient receives a notice from the insurance company summarizing the charges and payment for service. If the patient’s Health Plan covers the full amount, the Urgent Care center is remitted the amount directly by the insurance company. If the insurer pays only a part, the patient is billed for the balance.

It is important to note that each insurance plan is essentially a contract between the insurer and the insured, and each plan is different. So in order to avoid surprises later, one is strongly advised to check beforehand if an Urgent Care center belongs to the insurance company’s network of providers. In case of any questions, the patient should get in touch with the insurance company directly.

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