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Top Urgent Care Center Billing Mistakes, And Their Solutions


Take a look at these urgent care center billing mistakes, and how they can be fixed.

Healthcare landscapes are constantly changing.  As a result, urgent care centers keep seeing great growth.  Their ability to offer health care services so quickly and efficiently, and at an affordable price, makes them wildly popular.  Many urgent care facilities have wait times that don’t exceed 30 minutes, and visits don’t go for more than an hour.

However, while business is doing well in the urgent care market, urgent care centers could lose a lot of money if billing and coding mistakes are made.  Any mistake could determine whether a center is successful or not. Take a look at these urgent care center billing mistakes, and how they can be fixed.

Failure To Fix Poor Front Desk Processes

Urgent care center billing starts its revenue cycle at your front desk.  One of the most common mistakes in urgent care center billing is not having reliable processes that start at the front desk. Co-pays need to be collected at the start of a patient’s visit rather than the end.  Prior balances need to be gathered before new services are offered to the patients. If urgent care center billing procedures aren’t done properly, there can be lost revenue, rises in bad debt, and more patient accounts that go into collections.

The first step to remedying this problem is to establish financial processes that start at your front desk.  Train your front desk staff members in all of the necessary processes. Schedule regular retraining sessions to ensure your staff is always up-to-date on your procedures.

Having Bad Contacts in Place

When you’re setting up contracts with payers, you need to enter a legal agreement with the payer. In this agreement, the payer reimburses your facility according to your contracted fee schedule and then markets your facility as an in-network center within their network directory.  If you don’t set up contracts with your payers, you can’t accept insurance, so building patient volume becomes much more difficult.

Urgent care center billing is practically just as bad when you negotiate bad contracts.  If your contract has low reimbursement, you’re barely making any money for what services you provide for the patients.  You need to have fair reimbursement rates in place, ones that reflect the full scope of services you offer from your urgent care center.

Negotiating higher reimbursement rates can be tough.  But you might be able to negotiate higher compensation rates with payers.  You may want to hire a contracting expert who can handle your negotiations, making sure you get the best reimbursement rates as possible.

Incorrect Documentation or Under-Coding Charts

Even if you have great electronic medical records systems in place, your EMR is only ever going to be as good as the providers using it.  Not documenting items in the right places could result in accidental under-coding, which ends up with the facility bringing in less revenue. Providers also need to ensure they are documenting all history, exams, MDMs correcting in the EMR system so that the office visit codes are accurately reflecting what took place during the visit.

Part of proper urgent care center billing is making sure the providers are well educated on the proper use of the EMR system.  Refresher courses are useful now and then to serve as a reminder on how to use the EMR system.

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This entry was posted on Wednesday, July 24th, 2019 at 3:47 pm. Both comments and pings are currently closed.