Urgent Care Billing And Coding Mistakes

Urgent care facilities continue to expand rapidly as the healthcare landscape changes. Their capacity to deliver quick, inexpensive, and effective medical care is what fuels their popularity. In actuality, the majority of urgent care centers have wait times of 30 minutes or less, and the majority of visits last an hour or less. The demand for urgent care billing services is so high that between 2007 and 2016, private insurance claim lines for these services increased by 1,725%.

Ineffective front desk procedures not being fixed

The front desk is where your revenue cycle begins, and urgent care centers frequently make the error of neglecting to have effective financial procedures that start at their front desks. Make sure to collect co-pays at the beginning of patient visits rather than delaying this payment until the end.

Bad contracts already in place

Since contracts with low reimbursement rates mean you aren’t getting paid very much for the services you are providing patients, negotiating bad contracts can be almost as bad as not having any contracts. Negotiated reimbursement rates must be reasonable and reflect the full range of services your urgent care center offers.

It can be difficult to negotiate higher reimbursement rates with insurance companies because they are constantly looking for ways to cut costs. To raise compensation rates, it is possible to renegotiate with payers. Hiring a contracting specialist to handle negotiations on your behalf can frequently be the best course of action, ensuring that you receive the best reimbursement rates to support the expansion of your practice.

Failing to Follow Credentialing Guidelines

It’s crucial to realize that contracting and credentialing are two entirely distinct things with very different procedures. The process by which a payer confirms the knowledge, experience, and credentials of a provider in order to ensure patient safety is known as credentialing. Don’t make the costly assumption that all payers have the same credentialing requirements because each payer has different requirements.

Misleading or inadequately coded charts

Your urgent care center may have a fantastic electronic medical records system in place, but it is only as good as the providers who use it. Accidental under-coding can occur as a result of improper item documentation, which costs the facility a lot of money in lost revenue. Refresher courses could occasionally be beneficial as well.

Missing Important Charges

Missing out on important charges can cost your urgent care a lot of money, and incomplete documentation is frequently to blame. Patient visits can be so hectic that it’s simple to overlook recording a step, especially if instructions have been given verbally. X-rays, reading results, injections, blood draws, and labs are a few of the most frequently overlooked charges.

Additionally, healthcare professionals might neglect to record drug dosage amounts. It is important to accurately record the quantity of drugs dispersed so that payer claims can reflect the appropriate charges. Poor visit documentation will cause claim submission delays or claim denials. Your EHR software intelligent alerts can provide reminders when providers are locking charts.

Making Errors Claim Form Filling

Another significant urgent care billing and coding error you must avoid is making mistakes when filling out claims. Your claim may be denied if you forget to include code modifiers or if you use the incorrect modifiers.

4 Ways to Increase Urgent Care Revenue

The healthcare sector is essential because it helps people stay healthy and recover from illness, but it is also a business. In order for wellness centers to continue operating and helping the sick, it is crucial that they take the necessary steps to ensure their financial success. Here are four suggestions for increasing revenue for urgent care centers.

Revenue Cycle Management

Improving your revenue cycle management is the first and best tip for increasing urgent care revenue. This might necessitate additional front desk training. It includes crucial components like extending a warm welcome to every visitor and confirming that each patient’s insurance is in effect. Your front desk staff should receive sufficient training on the value of precision when it comes to patient registration and correct coding.

Employ technology

Online scheduling has some advantages for streamlining and organizing office procedures. On the other hand, you can make use of applications that facilitate payment calculation and prompt patient responses. Systems like electronic fund transfers are examples of how technology improves the efficiency of payment processing. The idea of telemedicine is gradually gaining in acceptance.

Extended Hours

Adults typically have daytime jobs, so taking time off to attend an appointment is very inconvenient. More patients will be able to visit the office after or even before work thanks to the extended hours. Because more people will be able to schedule appointments, your revenue will increase. If you don’t already have weekend or Sunday hours, think about adding them for the benefit of your clients.

Negotiation Power

It is not just about the patients when it comes to raising revenue. Everything is negotiable, including the costs of non-fixed expenses like cleaning services, office supplies, marketing, building leases, and other things.