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Urgent Care Billing Tips to Increase Revenue

There’s a lot more to urgent care billing than just coding and submitting claims—though doing those correctly will certainly have an impact on your bottom line. The medical billing cycle starts well before the claim form is started, and optimizing each step in the process will greatly increase overall revenue.

Start Before You Encounter Patients

Insurers and government payers are notoriously particular about details and one that urgent care facilities are sure to run into is timing. It is important not only to make sure that the patient is covered at the time of the appointment/encounter, but also that your paperwork is in order.

As an urgent care provider, you should make sure to be approved by all the local payers and have contracts in place. While you are setting this all up, negotiate for the best rates possible. Some payers are not flexible, but it is worthwhile to ask for the best rates from the insurers who can work with you on it.

Your Front Desk Plays a Key Role

In urgent care, the front desk won’t usually have advance notice and time to deal with insurers before the visit, so when each patient arrives, it should be standard procedure to collect the insurance information necessary to file for reimbursement and correctly inform the patient about any payment due from them and any bills they may receive in the future. Signing an affidavit of financial responsibility should also be a standard part of the patient check-in procedure.

While patients may not develop the same relationships with urgent care physicians that they have with their primary care doctors or specialists they see regularly, if they receive good medical care and are treated well by the staff, they are likely to return to the facility for future urgent care needs. Growing a client base takes time and effort, and it is always financially more beneficial to have returning patients than to constantly have to drum up new “customers” to keep the cashflow steady.

Patients are your customers and making them feel valued goes a long way towards establishing long term relationships. In addition to being compassionate, this also means taking the time to explain charges clearly and being willing to interface with insurers on their behalf if coverage is denied, but the service in question seems to be within their plan.

Maintain an Efficient Electronic Health Record (EHR) System

Running an effective urgent care clinic requires an efficient electronic health record (EHR) system. Just like a hospital or primary care facility, an urgent care facility may see the same patients repeatedly. It is important to have complete, up-to-date records in order to deliver the best possible care, in addition to the records being an important part of the medical billing process. Complete notes should be included for reference in case there are any issues with getting the claim reimbursed.

Claim denials or rejections need be tracked and appealed right away. This decreases reimbursement time, which keeps revenue up, but perhaps more importantly, it ensures that claims do not get lost in the system and abandoned. Millions of dollars are lost every year because claims get dropped instead of handling the issues that are the causes of the non-payments.

Keep Billers and Coders Current on Urgent Care Billing Changes

Not only do regulations change continually, but the codes themselves are updated annually and payers change their policies often. Situations like the COVID-19 pandemic make the changes much more frequent, but even under normal circumstances the changes happen.

Training in medical billing covers the basics, but every field of specialization has its own codes and modifiers. Billers and coders who are new to urgent care billing will need to be shown the codes and trained on using all the expected modifiers.

As the population continues to age, more and more Medicare patients will be coming in to urgent care facilities, so it is important that billers are familiar with the various programs and rules associated with that program.

Hire a Professional Medical Billing Company

Outsourcing urgent care billing to a professional medical billing company can be tremendously beneficial for your business. It takes a lot of time and energy to run an urgent care facility. By handing off the medical billing, you will free up your attention so you can focus on patient care.

The right medical billing service will have the experience needed to know how to navigate the current requirements and codes, and will have a system in place for managing claims to ensure that you get paid all the money you deserve.

The combination of our innovative revenue cycle management system and a staff of highly trained medical billers has made Medcare MSO highly successful at getting quick reimbursements and increasing overall client revenue. Give us a call today at 800-640-6409 to find out how we can do the same for you.

CategoryMedical Billing