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Three Common Mistakes in Urgent Care Center Billing and How to Resolve Them


Take a look at the three most common urgent care center billing and coding errors and solutions for these problems.

While the healthcare industry is still changing, there is growth among urgent care centers. They are popular because of how quickly and efficiently they can provide health care services and at an affordable price. Most urgent care facilities will not let people wait longer than thirty minutes, and most visits will take inside of an hour.

There is some risk in the urgent care market for losing revenue, though. All it takes is a few billing and coding mistakes to cost a significant amount of money. Take a look at the three most common urgent care center billing and coding errors and solutions for these problems.

Failure to Fix Bad Front Desk Processes

The front desk is where the revenue cycle begins. Urgent care center billing can go wrong when there are bad financial processes taking place at the front desk. Make sure you gather co-pays at the start of every patient visit rather than wait until the end. You should collect prior balances before you try offering new services to any of your patients. Failure to do this can raise your bad debt and lose you revenue.

To resolve this, you want to establish financial processes that always start at your front desk. The staff working at the desk should be well-trained in these processes. Every now and then, have retraining sessions for your staff members to keep everyone up-to-date on procedures.

Not Following Credentialing Guidelines

Part of urgent care center billing is to know that credentialing and contracting are different. Credentialing is the process that a payer uses to confirm the provider’s expertise, qualifications, and experience so they can ensure their patient’s safety. Because all payers have different credentialing requirements, you should never assume that all payers have the same requirements. You have to make sure that providers are credentialed with payers for urgent care centers to make sure that claims are properly processed.

Common credentialing problems that come up include a shortage of time, bad workflow and organization, and an inability to keep contract information current. To remedy these problems, you should hire credentialing experts who can work alongside you to navigate all of the credentialing requirements your payers have.

Wrong Documentation or Under-Coding Charts

Urgent care center billing means you need to have a solid electronic medical records (EMR) system in place. But, even if you have an amazing EMR system in place, it will only be as good as the providers using it. If you don’t document items in the proper sections, it can cause under-coding, which can cause you to lose revenue. Providers also have to ensure they document their exams, history, and MDMs correcting inside of the EMR system. That way, office visit codes will accurately show what took place during each visit.

Providers aren’t coding specialists; they treat patients. This is why it’s imperative to have your urgent care providers well-informed on how to properly use your facility’s EMR system. It can help to have occasional refresher courses to make sure the knowledge stays fresh.

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This entry was posted on Friday, December 13th, 2019 at 10:59 am. Both comments and pings are currently closed.