Reasons to Outsource Urgent Care Billing

Reasons to Outsource Urgent Care Billing: A Complete Guide

Despite having a profitable urgent care business with a respectable patient volume, favorable online ratings, and staff members committed to providing compassionate, evidence-based treatment, your profit margins are still lower than you had anticipated. Your billing procedures may be the problem if your income is underwhelming. Discover the fundamentals of urgent care billing and how a few simple adjustments may increase your practice’s revenue.

How Does the Urgent Care Billing Process Work?

Urgent care clinics serve an important role in our healthcare system by filling the gap between the primary care practitioner and the emergency department. That is most likely why they are gaining popularity and are anticipated to be valued at $26 billion by 2023. To claim a fair portion of the market, you must first understand the fundamentals of billing and how to optimize your workflows for optimum return.

Urgent Care Billing Begins at the Front Desk

Urgent Care billing is a cycle, and it starts at the front door. You may boost your revenues and spend less money on costly collection methods by establishing solid financial practices that begin at check-in.

Due to the walk-in nature of appointments, most urgent care facilities do not have a pre-registration process. When a patient requests an appointment, the receptionist or front desk employee must collect basic billing information.

The following information is essential:

  • Name, address, birth date, and purpose for visit are examples of basic demographic information.
  • The insurance company’s name, the primary care provider, and the policy number.

Ideally, information gathered during the registration process will aid in the development of an electronic health record (EHR). Within the EHR, providers, and support workers will collaborate to create patient notes, record health history, offer treatment suggestions, and more. A current patient record with detailed notes makes the billing process much more efficient. If a patient is a frequent visitor, it is critical to record any demographic or insurance information at each appointment.

Confirm Financial Liability

An Urgent Care Medical Billing clinic may not always have the time to call insurance companies to get treatment pre-authorization. Patients should be aware of their insurance information and understand the expenses associated with using a walk-in clinic. Prior to getting medical care, each patient must sign an affidavit of financial responsibility to avoid any billing disputes.

Follow-up After the Visit

When a patient receives services from a physician or other provider, all procedures and pertinent information should be recorded in the EHR. This aids in the preparation of an accurate bill, which aids in the formulation of the claim and the collection of the patient balance.

Submitting The Claim

In the billing process, the final step in delivering each medical operation to the payer is to tag and validate the operation for regulatory compliance. The bill sent by the insurance company contains critical information regarding the diagnosis, treatments, and related expenditures. Correct billing ensures a smooth reimbursement process, ensuring a timely reimbursement for healthcare providers.

The majority of healthcare practitioners file claims electronically because it is the most accurate and efficient method to get reimbursed. In general, medical software assists in the recording of patient information and the preparation of reimbursement claims.

Urgent Care Billing
                     Urgent Care Billing

Medicare and Urgent Care Billing

In general, urgent clinics can bill extra for their services using S codes since after-hours treatment is more expensive. CMS, on the other hand, maybe less reluctant to pay for urgent care medical billing treatments, and billing problems can only delay the payment process. Urgent care facilities are assigned a particular facility number (POS-20) by Medicare, but claims are processed as if they were a primary care office (i.e., using codes POS-10 or POS-11). Medicare will cover urgent care providers for services given, but it is crucial to remember that it may not reimburse institutions for the greater expenses associated with delivering walk-in treatment. As a result, healthcare practitioners who want to boost practice income should maximize the number of privately insured customers.

Urgent Care Billing Costs

When it comes to urgent care billing, you have two options: hire in-house coders and billers or outsource the process to a professional. Both will necessitate the purchase of software licenses as well as additional costs. While others want complete control over the billing process, having in-house billers and coders is more expensive. You will have to pay salary and benefits to in-house personnel, and an absence or sudden termination of employment can significantly impact your operation.

Why Should You Outsource Your Billing?

Appropriate, cost-effective practices are critical in your practice’s revenue cycle. Outsourcing can assist in increasing income and optimizing resources:

  • An outsourced billing business may assist you with all of your billing needs throughout the year, eliminating the need to account for unforeseen staff downtime. This also gives your personnel more time to focus on patient care tasks.
  • When compared to in-house workers, billing services are often better at collecting delinquencies.
  • Reduce your office’s hardware and software expenditures.
  • One of the primary reasons that urgent care centers prefer to outsource is convenience. A billing service provider conducts all data entry, corrects rejected claims, and distributes bills to patients. With the assistance of an EHR interoperability solution, data transmission is straightforward.
  • Allow your employees to concentrate on patient-care tasks, such as providing compassionate, evidence-based treatment that brings in additional patients.
  • Outsourcing reduces the chance of billing and coding errors, which serves two purposes: first, it streamlines the billing process and increases collections. Second, it assists in maintaining compliance with regulatory bodies such as the Office of Inspector General and the Centers for Medicare and Medicaid Services (CMS). Noncompliance expenses, even if unintentional, can have an impact on your revenue cycle management.

How does NEO MD deal with Urgent Care Billing?

Our dedicated staff of medical coders and billers can assist you in expanding your practice. Our team follows all Medicare Urgent Care Billing and Coding standards to guarantee optimum reimbursement. Claim denial and refusal danger are reduced through real-time, precise, rapid, and error-free coding of each claim and an early evaluation to assure claim eligibility. Many freshly constructed healthcare facilities are managed by leading revenue cycle management companies in the United States. Most healthcare businesses probably only use a few medical billing companies.

NEO MD Medical Billing has worked with several Urgent Care clinics around the United States. With over 15 years of experience in billing for emergency rooms and outpatient clinics, we have developed cutting-edge technologies that have altered the revenue cycle management sector.

NEO MD also provides medical billing services for small, medium, and large practices. In addition, we provide tailored billing services to practitioners in all 50 states. So, in order to obtain services, healthcare institutions locate the top Medical Billing company near me.

What Makes Us the Best Medical Billing Company?

NEO MD stood best among competitors’ Revenue Cycle Management Companies due to the following cores;

  • Our experts work hard to reduce your front-end denials by 20%.
  • Claim first level acceptance ratio; 95-97%
  • We have consistently increased the collection rate for our clients because of the faster increase in the accuracy of fees and collection.
  • Refunds adjustment and Payment posting to improve the cash flow.
  • Offer Services that are easily scalable at all times.
  • Offer Provider & Staff Productivity Analysis
  • Use the latest technology and tools.
  • Offering state-of-the-art medical billing services for small practices, medium-sized, and large ones.
  • Out of Network Negotiations.
  • Offer internal Medical Billing audits to uncover loopholes
  • Improve RCM system efficiency with a robust credentialing team. 
  • Provide fortnightly financial and practice overviews 
  • Deliver customized Revenue Cycle Management Services to unearth operation shortcomings.
  • Provide Urgent Care Billing and collection services that are of high quality and error-free.

Let’s Schedule a Demo to learn more about how we can improve your medical practice management. Get us at! ( or (929) 502-3636).

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