Sharpen Your Urgent Care Billing Practices

As per the experts, if an insurance claim is rejected or denied, it takes you five times the effort compared to the first claim submission. Reclaiming the denied reimbursement for rendered services is one of the major concerns for Urgent Care facilities. The good news is, there is a lot you can do in your Urgent Care billing practices across the front-desk processes, payor relations, coding practices and other segments of the revenue cycle to enhance your collections and keep your practice running like a well-oiled machine.

Best Practices in Urgent Care Billing

The demand for Urgent Care services is on the rise. It is a no-brainer that optimization of the Urgent Care billing process has naturally gained much importance in recent times too. Here we have listed some of its critical aspects to steer you towards building a more efficient revenue management experience.

1. Front-desk processes: You will find the highest turnover in this segment of your clinic. The crucial part of the revenue cycle starts right here. If there is any error in the information collected from the patients, your reimbursements are bound to struggle afterwards.

   a. E-registration – Utilize electronic patient registration systems to collect and record accurate patient data. Also, you can upload insurance images to check eligibility and acquire adequate information regarding each patient.

   b. Verify patient insurance – Real Time Eligibility (RTE) or Real Time Verification (RTV) is a feature that makes practice management (PM) ideal for Urgent Care facilities since you can confirm critical insurance details upfront, prior to the doctor seeing the patient. The best practice is to confirm the patient’s insurance on each visit and, depending on the outcome, advise them accordingly about coverage and financial implications.

2. Coding and insurance practices: A lack of awareness about the correct coding norms among clinic owners, management and providers is often a major reason for claim denials. If you do not understand the industry practices and standards within the Urgent Care billing processes, your facility is liable to face financial and legal consequences.

   a. Payor contracts- If there is an absence of payor contracts, or the existing contract is inadequate, it will impact on your clinic’s reimbursements. You must have a contract with the payors in your area for accurate reimbursements. A cash-only payment will reduce your patient flow, which will directly impact your revenue.

   b. Coding guidelines- Changes in coding guidelines always make it difficult to cope with. You need to understand the coding requirements and payor guidelines related to them for accurate billing. Also, you need to educate and train your billing staff regarding the coding practices to ensure streamlined billing workflow.

3. Metrics and audits: Identify and analyze your Urgent Care center’s performance metrics to understand operational and financial efficiency. The critical monthly metrics should include day sales outstanding (DSO), evaluation and management per visit, AR buckets older than 120 days, etc.

   You can update your standard operating procedure (SOP) to reflect practices that help you avoid making mistakes in billing and coding services. One employee may prove to be superior to another in a certain area; take advantage of this to do peer mentoring.

Harness the Sunknowledge Advantage

It can get very intimidating to manage your medical billing procedure while managing clinical responsibilities simultaneously. You might not be sure where you need the most assistance or what recommendations to start with. Choosing to outsource your billing is a major choice.

Get in touch with our experts who can handle all your Urgent Care billing intricacies with their wide knowledge and deep understanding of billing and coding guidelines. With 100% HIPAA compliance, we can streamline your revenue and reduce overhead costs by up to 80% almost instantly. We have been working in the healthcare billing realm for more than a decade with great references from both payors and providers. Our virtual assistants can provide you with a tailored service as per your requirements to maintain your practice’s revenue. Engage in a discussion with our experts to learn how we can help you navigate through the complex labyrinth of Urgent Care billing.