Avoiding Unpleasant Surprises in Urgent Care Billing

Common pitfalls in Urgent Care billing

If one were to use just one word to describe Urgent Care billing, it would probably be ‘complex’. There are just too many caveats to manage and considerations to take into account. A certain degree of notoriety is often attributed to Urgent Care billing due to its frequent propensity of getting denied or rejected. Medical billing, in itself, is a specialized and complicated area. With Urgent Care billing, everything moves a step higher.

The complex nature of Urgent Care billing has its origins in the intrinsic nature of this form of healthcare. In other words, the ambulatory nature of patients, the motley range of services that are typically offered, the somewhat ‘rushed’ and ‘immediate’ nature of the services provided, the lack of prior appointment – all of which define the true essence of ‘Urgent Care’ – lead to a large number of factors to be considered while billing. Add to this the myriad Health Plans available today (with more being added regularly) and their varying norms and requirements for billing, and it is not heard to understand how challenging the billing task can really be!

There are so many pitfalls that can lead to a claim getting turned down by the insurance payer. Missing out on providing the requisite information, using the wrong codes, dealing with lapsed or defunct policies, failing to submit a claim in time – these are just a few of them. But is there a way to eradicate them? Or lower the failure rate? Let’s explore.

Ensuring a better billing process

To cut a long story short and put it a bit bluntly, true efficiency in Urgent Care billing can be achieved only with the help of skilled, knowledgeable and dedicated billers. If you are blessed with such a panel of billers working for you, hallelujah! If not, you need to start building a better team.

Appointing the best billers can be an expensive proposition, because they don’t come cheap or easy. Maintaining a stellar billing team can also put a strain on operational cost. Most Urgent Care centers understand this, and so universally agree that the most viable solution, and also one that apparently checks out all the boxes, is strategic outsourcing of billing operations to specialized, professional third-party billing agencies. The advantages are many. For one, it helps in bypassing the steep labor costs of the domestic market and save more with the remarkably lower rates at which such third-party services are usually available.

Another major advantage is getting an almost instantaneous access to a vast pool of dedicated billers, coders and other revenue cycle management personnel without having to scour the employment market. The onus of training these personnel, providing them with the necessary infrastructure, and of being fully responsible for the best quality output, lies fully with these billing agencies. And with such excellent assurances, Urgent Care centers can finally have more time to focus on patient care than on chasing collections.