Patients come in for visits without appointments. Cards are distributed at a front desk in the insurance program. Tests in the lab are ordered. Procedures get performed. The entire thing should be charged right by the end of the day. If Urgent Care Billing were fast, then it would be no wonder that it's prone to mistakes. The greater the number of people that are seen in a day, then the greater the number of instances where there can be small issues regarding billing that will culminate in a lot of loss in revenue.

The Place of Service Code That Has to Be Right

All urgent care claims have to be submitted using a place of service code 20. If the billing system enters the wrong code on each and every claim, all claims are then sent out accordingly. Payment of claims for liability still takes place but at the wrong price. When an incorrect place of service code is used in the urgent care billing, the stream of billing goes through the system for weeks, and nobody realizes a mismatch. The home practice collects less on each claim during that period, and a majority of that amount is unrecoverable.

Billing Multiple Services in the Same Visit

At a doctor's visit to an urgent care center, a patient might be examined, have a lab test, and also be provided the hands-on wound care. Whether they are billable services or not varies by the bundling rules of the service payers. Those urgent care billers who aren't familiar with these rules for every healthcare insurance plan either bury a lot of services in one E&M or bill them out as separate services and receive denials. Both of these decrease the amount of what the practice will earn on each encounter that comes in that is affected.

Payer Mix and the Challenge It Creates

An urgent care clinic with a lot of people has 20 or more different insurance plans in one day. There are rules for each plan! There is a fee schedule for each! They each involve their own set of requirements and rules in formatting claims. When not handled appropriately by the urgent care billing system without any overlay of special knowledge about a particular health plan or its payer, they all get treated the same way, leading to a host of errors throughout each category. Specialist billing teams understand the unique characteristics of different payers and actively deal with them and don't have to learn about them from denial reports.

What Med Brigade Services Do That Changes How Practices Collect 

The vast majority of billing companies take care of the claims. Others investigate denials and revisit denials. Few end-to-end revenue cycle management teams actively manage the entire process in a way that would continuously yield better results. However, Med Brigade handles everything efficiently. 

Every Step of the Revenue Cycle Covered

In the case of the Med Brigade Services, they commence prior to the patient's arrival. Insurance gets verified. Benefits get confirmed. Authorization arrangements are put in place as needed. Once the visit is certified, coders have read all encounters. Claims are sent out using the correct codes and correct modifiers and documentation for all services billed. They post payments each day. AR is developed on a planned program. Denials are monitored from the source to be corrected.

Dedicated Account Management That Stays Accountable

Each of your clients receives his or her own account manager. A person who is knowledgeable about the routine and is responsible for the account. Not a contact that is rotated. Not a telco employee that reads! One loyal individual that can give answers with a firm grasp of the payer mix.

There are clear collection performance and denial trends reported, as well as trends in AR aging, in regular reports. Information that is available to help make actual decisions. Practices that have visibility into their revenue cycle make better decisions about it than practices that merely verify the end-of-month totals.

Who Benefits Most from Med Brigade Services

Practices that are expanding and don't desire to create an in-house billing department benefit. Bilingual staffing losses negatively affects practices. The loss of billing staff has a negative impact on practices. Any practice that is increasing its denial rates without a clear reason helps. All these practices are referred to as Med Brigade services and are handled by specialists that are held accountable for the outcome of their service and respond to it every single month.