The urgent care market is currently in good financial shape, and we can expect significant growth in the coming years. Even so, an urgent care center can’t afford to make costly billing mistakes if it wants to be successful. These blunders not only cost the center money but also reflect poorly on the organization. Let’s look at some of the best practices for billing at urgent care centers.
Charges Shouldn’t Slip Through the Cracks
In most cases, a patient’s visit to an urgent care center is quite frantic. It’s easy for a provider to get lost in the shuffle with all that goes on inside these facilities. It is not uncommon for important paperwork or documentation to be overlooked, resulting in unpaid charges. Forgetting to document lab work, injections, x-rays, and not listing the correct medicine dosage amounts are all common examples. As a result, it is critical that providers document all services immediately after they are rendered to ensure that nothing is overlooked.
When filing claims, make sure they’re accurate
When it comes to filing claims, errors are a major issue. The good news is that they are almost always avoidable. All required information must be included; otherwise, a denial may be issued. Some common errors include failing to include/insert the correct code modifiers, failing to specify the code clearly, and failing to write legibly. Claims must be double-checked before being submitted to avoid these types of errors. Another option is to outsource your medical billing to a team of trained specialists who will ensure that your claims are accurate.
The Front-End Is Prioritized
The revenue cycle is a lengthy process. It all starts when a patient approaches your front desk. As a result, you must ensure that your front-end processes are functioning properly. Patients’ existing balances, for example, should be requested before they can walk into their appointments. You’re setting your center up for revenue loss if you don’t have the right front-end processes in place. Your front-desk staff should be aware of what is expected of them at all times.
Top Urgent Care Center Billing Mistakes
The healthcare landscape is ever-changing. As a result, urgent care centers are continuing to expand rapidly. Their ability to provide health care services quickly, efficiently, and at a reasonable cost has made them extremely popular. Many urgent care centers have wait times of no more than 30 minutes, and visits are no longer than an hour.
While the urgent care market is booming, billing and coding errors could cost urgent care centers a lot of money. A single blunder could determine whether or not a center is successful. Take a look at these common urgent care billing blunders and how to avoid them.
Failure to Fix Poor Front Desk Processes
The revenue cycle of an urgent care center begins at the front desk. One of the most common billing errors in urgent care centers is the lack of dependable processes that begin at the front desk. Co-pays should be collected at the beginning of a patient’s visit, not at the end. Prior balances must be collected before new services can be provided to patients. If urgent care billing procedures aren’t followed correctly, revenue can be lost, bad debt can rise, and more patient accounts can go into collections.
Establishing financial processes that begin at your front desk is the first step in resolving this issue. All of the necessary processes should be taught to your front desk staff. Schedule retraining sessions on a regular basis to ensure that your employees are always up to date on your procedures.
Having the Wrong Contacts
You must enter a legal agreement with the payer when setting up contracts with them. The payer reimburses your facility based on the fee schedule you agreed to, and then markets your facility as an in-network center in their network directory. If you don’t set up contracts with your payers, you won’t be able to accept insurance, making it much more difficult to grow your patient base.
When you negotiate bad contracts, billing at an urgent care center is almost as bad. You’re barely making any money for the services you provide to the patients if your contract has a low reimbursement rate. You must have reasonable reimbursement rates in place, ones that reflect the full range of services you provide from your urgent care center.
Higher reimbursement rates can be difficult to come by. However, you may be able to negotiate higher pay rates with payers. You might want to hire a contracting expert to help you with your negotiations so you can get the best reimbursement rates possible.
Under-Coding Charts or Incorrect Documentation
Even if you have excellent electronic medical record systems in place, the quality of your EMR will always be determined by the providers who use it. Failure to properly document items may result in unintentional under-coding, resulting in lower revenue for the facility. Providers must also ensure that all history, exams, and MDMs are accurately documented in the EMR system so that the office visit codes accurately reflect what occurred during the visit.
Making sure the providers are well-versed in the proper use of the EMR system is an important part of proper urgent care billing. Refresher courses are beneficial from time to time to remind users how to use the EMR system.
Three Common Billing Mistakes and How to Avoid Them in Urgent Care Centers
While the healthcare industry is still evolving, urgent care centers are expanding. They are well-liked because of the speed and efficiency with which they can provide health-care services at a reasonable cost. Most urgent care centers will not keep patients waiting for more than thirty minutes, and most visits will be completed within an hour.
However, there is a risk of revenue loss in the urgent care market. A few billing and coding errors can quickly add up to a significant financial loss. Take a look at the three most common billing and coding errors at urgent care centers, as well as the solutions to these issues.
Failure to Fix Bad Front Desk Processes
The revenue cycle starts at the front desk. When there are problems with financial processes at the front desk, billing at an urgent care center can go wrong. Rather than waiting until the end of each patient visit, collect co-pays at the beginning. Before you try to offer new services to any of your patients, you should first collect previous balances. Failure to do so may result in an increase in bad debt and a loss of revenue.
To address this, you should establish financial processes that begin at the front desk. The people who work at the front desk should be well-versed in these procedures. Hold retraining sessions for your employees every now and then to keep everyone up to date on procedures.
Not Following Credentialing Guidelines
Knowing the difference between credentialing and contracting is an important part of urgent care billing. Credentialing is the process by which a payer verifies a provider’s expertise, qualifications, and experience in order to ensure the safety of their patients. Because each payer has its own set of credentialing requirements, you should never assume that they are all the same. To ensure that claims are processed properly, you must ensure that providers are credentialed with payers for urgent care centers.
Time constraints, poor workflow and organization, and the inability to keep contract information current are all common credentialing issues. To address these issues, you should hire credentialing experts to assist you in navigating all of your payers’ credentialing requirements.
Outsource healthcare credentialing services and get the payment without missing a single dollar.
Under-Coding Charts or Incorrect Documentation
Billing for urgent care centers necessitates the use of a reliable electronic medical records (EMR) system. However, even if you have a fantastic EMR system, it will only be as good as the providers who use it. If you don’t document items in the appropriate sections, you risk under-coding, which can result in revenue loss. Providers must also ensure that their exams, histories, and MDMs are properly documented in the EMR system. As a result, the office visit codes will accurately reflect what happened during each visit.
Patients are treated by providers, not by coders. This is why it’s critical that your urgent care providers understand how to use the EMR system at your facility. It’s a good idea to take refresher courses every now and then to keep your real-time data.
