In recent years, the country has seen a growth in urgent care centers. Various factors such as affordability, transparency and efficiency in service delivery in fact are fueling the market growth. As a result, the UCCs are strained and experiencing hindrance. The hurdles in urgent care billing are reflecting on the revenue cycle of the practices and it has become a major concern for the providers.
Reasons for Higher Risks of complications in Urgent Care Billing
In addition to time sensitivity of their operations, there are other reasons which are contributing to the intricacies of billing process.
- Different services: Urgent care centers deliver a wide variety of services from basic primary care to minor surgeries and treatment for injuries and diagnostic tests. Managing the coding and billing for these services elevates the complexity of the process.
- High patient volume: Due to the faster care and transparency of services, the increasing patient volume within the sector is posing challenges in billing and coding process.
- Incomplete patient information: The imperativeness of the services does not allow the providers to access complete patient information. As a result, there is always a higher risk of inaccurate documentation which leads to claim denials.
- Various insurance providers: The UCCs often deal with a mix of payers with different claim submissions and reimbursements requirements. If your billing staff is not properly trained or the systems are not integrated accurately you might face issues regarding billing services.
How to Avoid These Urgent Care Billing Mistakes
- Accurate front desk process: The revenue generation process begins with effective patient insurance eligibility verification. Your front desk staff needs to collect correct information to reduce the risks of delayed reimbursements and claim denials.
- Adequate payer contracts: Without payer contracts, providers do not have any agreement on rendered service charges or they might receive lower payments. A lack of contracts with the payer therefore results in financial losses and the quality of services is also reduced.
- Reduce the coding and documentation errors: This is very common yet a disastrous mistake in urgent care billing. UCCs provide a range of services that include but are not limited to ICD-10 and CPT coding. A gap between services rendered and services coded and documented can result in financial loss. Furthermore, under coding and up coding for the services provided can also result in audit and penalty issues. This ultimately leads to revenue loss and deteriorating financial health of your practice.
Final Thoughts
No matter how big or small your practice is building a revenue cycle is necessary for the financial health. The best way to tackle the urgent care billing issues is to develop strategic partnerships. Outsourcing an RCM company can be a strategic approach in your medical billing and coding process. An outsourced company has a set of experienced and dedicated professional who can provide you with tailored healthcare billing and coding services. Furthermore, they have the ability to work across different software systems which ensures your data security. The transparency within the overall process helps you gain back control of your practice’s financial health. Not only that, but as the outsourced professionals are well-versed with the coding and billing intricacies, you don’t need to invest your time to educate them. This reduced your overhead expenses while minimize the risks of errors within the coding and billing processes. Partner with a company who has access to a large pool of talent so you can have the correct resource to revamp your revenue cycle.
