“Learn the basics of urgent care billing to boost the revenue of your practice”
The rising requirement for urgent care facilities is the reason for their financial success. Their popularity is due to the number of patients who need urgent care. The prime task of such centers is to render care services for accidental or unpredicted ailments that are not lethal.
Patients see urgent care facilities as economical, prompt, and efficient. The fact that patients don’t need any prior appointments for availing services makes it even more effortless. However, the size of everyday visits makes the process of urgent care billing challenging.
Where the healthcare providers are busy offering services to those in need, taking time out for billing becomes a hassle. Medical billing is such a domain that requires undivided attention and failure leads to consequences. The results hamper the growth of healthcare practice and lead to unfavorable revenue.
However, urgent care billing services are a great option to keep the revenue cycle in check. An urgent care billing company makes the management of administrative tasks and operational activities trouble-free.
Boosting the bottom line of healthcare practice can be overwhelming and stressful. As a result, there are more errors and setbacks in revenue cycle management. A foolproof method to prevent the practice from such issues is understanding the basics.
Let's begin this blog by touching on the topic of basics to know more and understand better.
The Process of Urgent Care Billing
Urgent care facilities are in between primary and emergency care. Their accessibility helps in improving the financial posture. However, to benefit from this situation, there is a need to acquire the knowledge of the basics. The answer to the question - “How does urgent care billing work”, will elevate the performance and result in optimum efficiency and maximum profitability.
Initial Step in Urgent Care Billing
The process of urgent care billing works in a loop that begins with a patient’s entry into the facility. This is the very point to set the foundation of administrative success.
There are no prior registrations in urgent care centers. The nature of patient visits is walk-in. This raises the importance of recording information accurately. This is the task of the front desk and detailed data must be collected at this point. This is also vital as this is the registration phase for visitors.
The information recorded here includes:
Demographic data like name, date of birth, cause of visit, and address. Other essential information is details regarding the insurance company, policy number, and primary care provider.
With the advent of technology, the registration process has changed, and currently all data is recorded and preserved via EHR (Electronic Health Records). Healthcare providers and staff members must ensure that they integrate the medical billing process and use EHR.
This step is vital to keep the process up to date and align the overall urgent care billing. In case of revisits, there needs to be an update in the patient information with every visit.
Establishing Financial Responsibility
Urgent care facilities are always experiencing the hustle and bustle of patients. Due to this, there is less time to manage the administrative process, leaving limited time to cross-check with insurance companies. As getting prior authorization is difficult, it becomes important that patients are aware of their financial responsibility. This familiarization process is a way to prevent billing complexities. Every patient is required to sign an affidavit of their financial responsibility before availing healthcare services.
Follow-up After Rendering Services
Once a patient has already received services, it’s time to carry on with some follow-up procedures. This step involves recording all relevant information in the EHR. This step is important as this is the place to not only ensure accuracy but also prevent missing or duplicate information. This aids in the further process of coding and submissions.
Final Step – Claim Submission
After all patient data is translated into urgent care billing codes while following all the regulatory requirements and claims are filed, the final step is submissions. Once the submission is done, the rest of the process is carried out by the insurance company. It checks if the claim is correct and holds complete information to approve revenue. The absence of any errors in claims helps in getting complete revenue and improves the bottom line of the practice as well.
If this step is handled efficiently, it also reduces the chances of denials and rejections. Most of the claims today are submitted through electronic mode. This is a faster way to well-deserved revenue. Many healthcare providers get assistance from urgent care billing services and get benefits to their advantage.
Difference Between In-house Urgent Care Billing and Outsourcing Billing Partner
The major difference between these two is the cost-efficiency of an outsourcing partner. When a healthcare practice has an in-house billing team, it must finance the salaries of the staff and invest in training programs. Along with that, there is the expense of a working space. All this can add up and become financially challenging.
Such an issue doesn’t exist with an outsourcing partner. An urgent care billing company provides all the billing-related services and healthcare providers can get these; while being cost-efficient.
Reasons to Outsource Urgent Care Billing
Being cost-efficient is not the only advantage of urgent care billing services. Medical billing service is like an urgent care billing cheat sheet for healthcare providers. There are other benefits of partnering up with a professional billing partner and they are:
- Urgent care billing companies offer services throughout the year leaving no trouble regarding employee turnover and leaves. The administrative activities are always on track and never miss any deadlines. This gives care providers the chance to enhance the quality of their services and patient relationships.
- Outsourcing partners eliminate the possibility of human errors that usually occur with the in-house billing team. The documentation is smooth as electronic methods of recording are preferred.
- Urgent care billing services are more convenient. They eradicate the hassle and burden of medical billing by taking care of every step in the process. Whether it is documentation or denial management, everything is under control. Even data transfer is trouble-free.
- Choosing a medical billing service reduces the risk of errors. An accurate process ensures that mistakes and missing details are limited. As a result, there are limited denials, hence the process and operational activities become more streamlined. Achieving reimbursement becomes effortless leading to exponential financial growth.
- Patient information is also protected under regulatory guidelines such as HIPAA and this protects patient information from unauthorized access. The protection of patient data is essential to prevent healthcare practice from legal actions and reputational loss.
Important Urgent Care Billing Guidelines
As urgent care billing services are beneficial for healthcare practice, there are certain guidelines to take care of and they are:
The first thing is to use specialty-specific codes. It is important to know the difference between urgent care codes and primary care codes. This need arises as both urgent care facilities and primary care facilities provide treatment for the same ailments. The thing to keep in mind is that urgent care codes start with an “S”, and this is not the case for primary care codes.
The two major types of codes are:
S9088 –This code is meant to realize the fluctuation in treatment charges and ensure that healthcare providers receive some portion of the elevated price as revenue. This code is a combination code always paired with E/M (Evaluation and Management) codes.
S9083 – This code allows healthcare providers to collect universally accepted charges for the rendered services.
Generally, urgent care billing codes fall in the category of CPT and ICD-10 codes just like any other branch of medicine. When it comes to CPT codes, there are three categories:
Category 1 Codes These codes evaluate and manage disease, surgery, radiology, pathology and laboratory testing, medicine, and anesthesiology.
Category 2 Codes – They are optional codes that are not a substitution for Category 1 codes. These codes are used for quality assurance.
Category 3 Codes – These codes are used for new procedures that are not yet approved by the FDA.
In the case of urgent care billing, only Category 1 codes are used. Other common codes for urgent care billing are 99214, 99213, and 99204.
Conclusion
Urgent care medical billing is a daunting task, and an outsourcing partner is a savior in this situation. There are enough benefits to opt for urgent care billing services to shift the burden and focus on what is more important – patient care.
Unify Healthcare Services is a professional and well-known medical billing company that offers billing solutions to various branches of medicine. Urgent care billing is one such domain and Unify; has expertise in it. With a team of well-trained billers and coders, we offer precise medical billing to elevate the performance of your practice. We offer custom-made services to improve operational workflow while maximizing revenue.
