Urgent care billing is complex due to coding, insurance, and regulations. Urgent care billing services can streamline this process by handling tasks like insurance verification, coding, claim submission, and denial management. This can increase revenue, improve efficiency, and free up staff time for patient care. Consider experience, technology, customer service, and cost when choosing a service.

Billing Care Solutions Services Guidelines

Revenue Cycle Management (RCM):

Don’t get bogged down in paperwork. Billing Care takes the wheel, streamlining your entire RCM process. Their expert team handles everything from patient registration and insurance verification to claim scrubbing and denial management. This frees up your staff to focus on delivering exceptional care to patients, not chasing down paperwork.

Account Receivable Management:

Outstanding balances can cripple your cash flow. Billing Care implements efficient billing practices and targeted collections strategies to get you paid faster. They’ll identify and address potential issues early on, minimizing write-offs and keeping your revenue cycle flowing smoothly.

Provider Enrollment & Credentialing:

Getting credentialed with multiple insurance companies can be a bureaucratic nightmare. Billing Care’s team of specialists’ cuts through the red tape, handling the complex enrollment and credentialing process swiftly and efficiently. This ensures you get paid promptly for the services you provide.

Eligibility & Benefit Verification:

Avoid claim denials due to coverage issues. Billing Care proactively verifies patient insurance eligibility and benefits upfront. This allows you to identify any potential problems before services are rendered, saving you time and money.

Authorization and Referral Services:

Prior authorizations and referrals can create delays for patients. Billing Care solutions takes the burden off your staff by obtaining these approvals efficiently. This ensures patients receive the treatment they need without unnecessary hold-ups.

Business Intelligence on Steroids:

Gain deeper insights than ever before with Billing Care solutions customized business intelligence reports. Billing Care solutions go beyond basic metrics, providing actionable data that helps you identify areas for improvement and optimize your entire revenue cycle. Billing Care solutions use these insights to fine-tune staffing, coding practices, and collections strategies, maximizing your profitability.

Patient Support:

Billing questions can be a source of frustration for patients. Billing Care solutions provides a dedicated patient support team to answer inquiries and resolve billing issues quickly and efficiently. This not only improves patient satisfaction but also reduces the administrative burden on your staff.

Coding System

Current Procedural Terminology (CPT codes):

These codes describe specific services provided during a visit, such as office visits, injections, or minor surgeries. Here are some common CPT code ranges used in urgent care:

• 99201-99205: Evaluation and Management (E/M) for new patients. This range represents the complexity of the visit based on factors like time spent and medical decision-making.
• 99211-99215: E/M for established patients. Similar to new patient codes, but for patients with a prior history at the facility.
• 10060-10061: Incision and Drainage of Abscess. Codes within this range specify the complexity of the abscess treatment.
• 10120-10121: Removal of Foreign Body. These codes depict the location and difficulty of removing a foreign object.
• 12001-13160: Wound Repair (Simple, Intermediate, Complex). This range covers various wound closure procedures based on size and complexity.
• 29125-29131: Application of Splints (Extremities). These codes specify the type of splint applied to an extremity.
• 99281-99285: Emergency Department Visits. While urgent care isn’t an emergency room, these codes might be used in specific situations.

Healthcare Common Procedure Coding System (HCPCS codes):

These codes supplement CPT codes for certain services or supplies not included in the CPT system. They often begin with a letter followed by a five-digit number.

International Classification of Diseases (ICD-10 codes):

These codes diagnose the patient’s condition. Accurate ICD-10 coding is crucial for linking the service provided (CPT code) to the medical necessity (ICD-10 code).

Modifiers

Place of Service (POS) modifiers:

These identify the location where the service occurred. Examples include:

• 25: Office service (typical for urgent care visits)
• 99: Mobile transport service

Evaluation and Management (E/M) modifiers:

These further define the complexity of an E/M service. Examples include:

• 24: Unrelated E/M service during the postoperative period (within a specific timeframe)
• 25: Significant, separately identifiable E/M service on the same day as another procedure

Other common modifiers:

• 59: Distinct procedural service (performed separately from the primary procedure)
• 22: Increased procedural service (more complex than typically performed)
• 51: Multiple procedures performed during the same surgical session.

In conclusion, partnering with Billing Care Solutions is an investment in the future of your urgent care center. Their targeted approach can improve your financial health, free up your staff’s time, and ultimately allow you to focus on what matters most – providing excellent patient care.

We specialize in Medical Billing and Coding and provide comprehensive support for your practice. For more information visit

For more details on billing softwares, visit