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Billing “Urgent Care” As It Emerges As One of the Fastest Growing Specialties

October 03, 2012

Urgent care is fast developing as a viable alternative to what has traditionally been known as “family practice”. The main reason behind this new-found fancy is that physicians can now operate from designated facilities without having to trek around offices, nursing homes, and hospitals. Additionally, urgent care centers are preferred to other similar types of ambulatory healthcare centers, such as emergency departments, and walk-in primary care centers by the scope of illness treated and facilities available on-site. It will not be long before we witness further addition to already 8,700 urgent care centers (UCCs) across the US.

While it is true that practicing Urgent care offers physicians an extended scope and avenue for revenue generation, there are certain criteria (established by The Urgent Care Association of America) that physicians must abide by. These criteria describe scope of service, hours of operation, and staffing requirements. A qualifying facility must treat walk-in patients of all ages during all hours of operation. It should treat an entire range of illnesses and injuries, and have the facility to perform minor procedures. An urgent care center must also have on-site diagnostic services, including phlebotomy and x-ray. Because of this inclusive medical service coverage, Urgent care medical billing has become far more complex than usual. Urgent care physicians will be called upon to deal with:

  • Code that allows urgent care centers to code and get reimbursement for the extra expenses involved in providing urgent care services
  • Code that allows the urgent care center to receive reimbursement at one flat rate (Global Fees for services rendered at Urgent care centers) for all visits coded with it
  • The usage of evaluation and management (E/M) codes as per EMTALA guidelines if it is a Type B emergency department
  • Facility codes in urgent care
  • National Provider Identifier (NPI)
  • E/M Code plus Procedure Code in Urgent Care
  • Level 1 E/M Code 99211
  • Codes for services rendered during extended hours
  • E/M Code + IV injection procedure code

Added to this complex coding is a reimbursement environment which has become more restrictive post a series of healthcare reforms recently. This additional burden of revenue cycle management (RCM) to an already overweighing clinical schedule may impede the very focus of clinical excellence. This is precisely the reason why physicians are turning to specialist billing and revenue cycle management from “urgent care medical billers”. Consequently, there has been an unprecedented demand for billers and coders in this domain.

At a time when the market is still peaking, Medicalbillersandcoders.com – the leading source for specialist billing and RCM services – has taken the lead in supplying the right billing and RCM sources to urgent care practitioners. Spread across all the 50 states in US, we provide experienced billing experts for urgent care billing & RCM for your medical practices.

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