How Can Urgent Care Billing Services Help You Streamline Your Practice?

In current society, emergency care centres play an integral part in providing convenient and appropriate medical care for sudden injuries and non-life-threatening diseases. According to the Urgent Care Association, the USA has reported more than 9000 urgent care centres where about 342 patients visit weekly. As the demand for urgent care centres increases, the need for automation to streamline urgent care billing processes grows. 

 

Around 43% of medical centres need more billing and collection processes, leading to financial instability and loss in revenue. To overcome such issues, automation in urgent care billing processes must be implemented to improve billing operations, accelerate cash flow reimbursement, increase efficiency, and minimize errors.

 

However, it’s not like all medical billing firms do their job efficiently. Besides, some are more compatible with episodic visits than urgent care settings. For instance, if a medical claims processing system includes a clearinghouse solution, it’s important that the medical billing software also performs well with the clearinghouse.

 

If they’re compatible, it can cause issues that save time, create stress, hold up approvals and reimbursements, and lead to problems with cash flow. That wastes your time and money. Therefore, you should pay close attention while outsourcing Urgent care billing services for your company.  

 

Automation to Streamline Urgent Care Billing Processes 

The right urgent care billing services provider will optimize the efficiency in office management tasks. 

 

The services include user-friendly opportunities to reduce denials, accelerate the revenue cycle and provide complete reports tailored to all aspects of the company’s practice management. Hence, the software will effectively and reliably address all the money obtained through submitting claims.

Steps of the Urgent Care billing process

 

1. Registration and check-in: 

The Urgent Care billing process starts with the patient’s registration and check-in. It includes gathering patient information, verifying their insurance coverage, and getting consent for billing and treatment.

 

1. Medical Documentation: 

 

All the services provided are documented in the EHR (Electronic Health Record) as soon as doctor visits and checkup of a patient and decoded into medical coding, i.e., ICD-10-CM, HCPCS, and CPT codes. 

 

1. Generate Claims: 

These codes are generated and submitted for reimbursement to the patient’s insurance provider.

 

1. Follow-up and Request:

 

 The urgent care facilities will contact the insurance provider for follow-up if the claim is not fully compensated or denied, and then submit a request to resolve the issues instantly.

Reasons to outsource rehab billing services:

An outsourced rehab billing service can assist you with year-round billing requirements without the need to account for unexpected employee interruption. It will allow your staff members to spend more time with patient care activities. 

 

• Generally billing firms like CureCloudMD act better at gathering felonies than in-house staff.

 

• It saves money spent on hardware and software costs in the office. 

 

• Also, it helps staff members focus on patient care tasks, including offering compassionate, evidence-based care to encourage more people to use your urgent care services.

 

• One of the main reasons behind hiring urgent care billing services is convenience. The billing provider manages all data entries, fixes rejected claims and sends patients receipts. 

 

• Additionally, an EHR interoperability system enables the smooth and efficient transfer of data.

Urgent Care Billing Guidelines

For urgent care and primary care, billing processes are much alike as the way to treat problems is similar. 

There are some specific codes that are only applicable to urgent care facilities. The urgent care billing codes start with ‘S .’

Two primary code groups are being used for urgent care for billing purpose, excluding Medicare.  

• S9088:

S9088, referred to as “services provided in an Urgent Care centres,” that allows Urgent Care centres to charge for diagnosing and treating medical conditions, knowing that the services provided in an urgent care facility are typically more costly. 

The code S9088 works with the proper evaluation and management code (E/M code). 

The urgent care billing code allows the centres to get back a refund for at least a share of the increased amount of giving immediate care. 

• S9083:

 

S9083 is a billing code that permits Urgent Care centres to charge a fixed fee for a single service, regardless of the patient’s required care. 

Sometimes, a managed care organization (MCO) may need a hospital to use the S9083 billing code. Although, several MCOs in states such as Florida and Arizona command Urgent Care centres to use S9083 to bill for all services. 

 

It’s better to avoid the S9083 code as much as you can. Why? There is a simple reason behind this statement. According to a global fee-for-service scale, urgent care will charge the same amount for treating a nosebleed as it would assess to treat a cardiac arrest. 

Otherwise, these two S9088 and S9083 codes cater to virtually all urgent care visits. (S9088 with add-on CPT E/M Codes and S9083 as it is). There are several other S codes, but all fall under these two codes excluding Medicare. 

Medicare codes differ from these, and the reimbursement rate relies on geographic location, proven medical need, and other factors. Before presenting a bill to a payer, it must fulfil specific regulatory requirements, such as compliance with HIPAA and the Inspector General Officer. 

A biller must confirm that each charge can be payable based on the payer’s rules. However, denied claims complicate further billing process, time-taking processes and waste staffing resources. 

Significance of Automation to Streamline Urgent Care Billing Processes

• Urgent care facilities are a crucial part of the healthcare industry as they provide non-emergency medical assistance to patients on a walk-in basis.

 

• An efficient and exact billing process is essential for the urgent care billing process’s financial steadiness as they ensure that services offered to patients are compensated instantly and accurately.

 

• Automated systems can provide real-time access to data and analytics, enabling Urgent Care facilities to monitor their financial activities and make informed decisions to optimize revenue and improve overall efficiency.

 

• However, inefficient billing causes delays in payments, claim denials, patient dissatisfaction, compliance, and other issues that can adversely affect the revenue cycle and overall operations. 

 

• Adequate billing operations can minimize the risk of claims denial, which leads to improvement in revenue loss and timely payment, improving the financial stability of the service providers. 

 

• An efficient billing system can enhance patient satisfaction, as payers claim immediate and accurate billing data. 

 

Any delays and errors that occur in billing will have an adverse impact on their experience with the urgent care facilities. 

 

• Consent with regulatory bodies and industry standards, i.e., HIPPA, is important to prevent the charges and penalties that can be costly for the service providers. 

 

Therefore, keeping compliance with the authority, proper documentation and managing patient data are key aspects of urgent care billing guidelines. 

 

• Lastly, hiring specialized software, AR Recovery services and expert revenue cycle management staff can lead to an honest and effective billing process that means growth of the financial health providers and improved patient care.

Conclusion

Automation to Streamline Urgent Care Billing Processes is important to improve operational efficiency and maintain the financial well-being of your facility. 

You can achieve this by incorporating an EHR system, verifying insurance coverage, providing staff training, and monitoring billing performance.

These steps can reduce errors, decrease claim denials, and maximize profit. 

Moreover, you can outsource your urgent care billing to a professional company, i.e., CureCloudMD, to boost your billing process even more and keep your focus on providing exceptional patient care.