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Tuesday, May 21, 2024

Top Urgent Care Billing Challenges and Solutions

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Healthcare environments are ever-changing. As a result, the number of urgent care billing centers continues to expand rapidly. Their capacity to provide health care services swiftly, efficiently, and affordably has made them extremely popular. Many urgent care centers offer wait periods of little more than 30 minutes, and appointments are no more than an hour.

However, even if the medical industry is performing well, urgent care billing and coding errors might cost institutions a lot of money. Any mistake could decide whether or not a center is successful. Take a look at these urgent care billing problems and how to avoid them.

Inability to acknowledge inefficient front-of-house processes

The revenue cycle for urgent care facility billing begins at your front desk. One of the most prevalent faults in urgent care billing is the lack of dependable systems that begin at the front desk. Co-pays should be collected at the beginning of a patient’s appointment rather than at the end.

Prior balances must be collected before new services can be provided to patients. If urgent care billing procedures are not followed correctly, there may be lost revenue, an increase in bad debt, and an increase in patient accounts that go into collections.


The first step in resolving this issue is to establish financial systems that begin at the front desk. Train your front-desk employees on all of the relevant procedures. Schedule retraining workshops regularly to guarantee that your workforce is always up to date on your practices.

Having Unfavorable Contracts

When establishing contracts with payers, you must engage in a legal agreement with the payer. In this agreement, the payer reimburses your facility based on the price schedule you agreed to and then offers your facility as an in-network center in their network directory. You can’t accept insurance if you don’t have contracts with your payers, thus, increasing patient volume becomes much more difficult.

When you draft lackluster contracts, urgent care billing facility charging becomes unreliable. If your contract has a low reimbursement rate, you’re barely making a living for the services you deliver to patients. You must have appropriate reimbursement rates in place that represent the entire range of services provided by your urgent care clinic.


It can be difficult to negotiate higher reimbursement rates. However, you may be able to negotiate greater pay rates with payers. You might wish to engage a contracting professional to handle your discussions and make sure that you get the highest reimbursement rates possible.

Inadequate documentation or under-coding

Even if you have excellent electronic medical records systems in place, your EMR will only be as good as the doctors that use it. Failure to document items in the proper locations may result in unintentional under-coding, resulting in less revenue for the facility.

Providers must also verify that all history, examinations, and MDMs are correctly documented in the EMR system so that the office visit codes accurately reflect what occurred during the visit.


Make sure that certain clinicians are fully informed on how to use the EMR system. It is an important part of a proper urgent care billing center. Refresher courses are useful from time to time to remind you how to use the EMR system.

Sunknowledge is the most complete urgent care billing system in the market.

Sunknowledge can assist you in getting your claims settled and minimizing your losses in this case. Our proactive and simplified revenue cycle management strategy assures a steady flow of cash into your organization while also providing you with comprehensive insight and certainty of your payments at every level of the urgent care billing process.

Sunknowledge excels where others falter:

  • We do provide full Urgent Care Billing and Coding Support at 2.9% of collections from all services.
  • We are the sole RCM service provider that offers hands-on assistance
  • Any price can be met or exceeded
  • Industry references with a good reputation
  • Our team guarantees that there will be no backlog as we operate on all 7 days of the week

We provide hands-on support through CPC-certified coders and urgent care billing staff who understands what it takes to recover your cash flow. We guarantee that no one can match our adaptability and incredible consistency. In addition, we provide a $3 million insurance policy that covers any computer hacking.

Hence to conclude, addressing these urgent care mistakes can result in large revenue improvements for your clinic. If you are unsure whether your center is making these errors or need assistance in addressing them, contacting a competent urgent care billing business that specializes in urgent care revenue cycle management, such as Sunknowledge, might be advantageous.


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