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How Smart Coding Workflow can enhance the revenue integrity of Urgent Care Centers

Urgent Care Centers (UCC) are booming

As the healthcare landscape evolves and continues to change, Urgent Care Centers continue to experience rapid growth. UCC growth is expected to continue, with the market expected to hit $26 billion in 2023.

The primary reason for their popularity is the ability to provide healthcare services affordably while being efficient and fast. However, most Urgent Care Centers have an average wait time of lesser than 30 minutes.

Business is good but UCCs are losing money

UCCs are likely to lose thousands of dollars if they make billing and coding errors. A stand-alone Urgent Care Centre can lose anywhere between $200,000 to $500,000 annually.

Urgent Care Centre Coding and Reimbursement

Urgent Care services are coded based on the level of services rendered by the physicians to the patients. Most of the reimbursement is based on a flat rate that combines the services and other procedures performed on the same day.

UCC medical billing and coding is ever-changing

The problem and challenge – Urgent Care Centre medical billing and coding is constantly changing.UCC’s may participate in national vaccination and immunization programs or may have to address topical ailments. Constantly updating the systems and training of staff with emergent billing and coding poses huge challenges. As coding and billing are mostly done manually, the process is prone to errors while being inefficient and lacks scalability. Hence, UCCs suffer from delayed payments, loss of revenue, lower patient satisfaction.

Typically, UCC medical coding is a mess

UCCs across the country are leaving thousands of dollars on the table – the primary reason is faulty medical coding. The most efficient and innovative way to fix this problem is by deploying smart medical coding and auditing tools to increase your coding accuracy and throughput.

Minimize claim denials, improve Revenue Integrity

The revenue cycle success starts with patient registration and continues throughout the claims cycle. Gathering the right patient demographics and financial information right from the beginning results in reduced denials, fewer rejected claims and fewer returned statements.

Effective revenue cycle management plays a key role in ensuring that UCCs stay profitable. For this to happen, coding workflows need to evolve, become smarter and error-free. Here are some steps you can take towards avoiding coding mistakes and minimizing claim denials:

  • Ensure that everyone who touches a patient record understands the importance of accuracy, from patient registration and charting to E/M codes
  • Avoid incorrect or incomplete documentation
  • Avoid under-coding
  • Up-coding can initiate audits

Smart medical coding and your revenue cycle

Smart medical coding enables accurate translation of a provider’s description of the disease, injury, and procedures into universal medical code numbers for the insurance claim.

Smart medical coding can enable UCCs to align their services with a medical diagnosis. Backed by a combination of Artificial Intelligence (AI), Natural Language Processing (NLP), Big Data, and Machine Learning – smart coding enables higher accuracy, faster medical coding turnaround times and a drastic reduction in manual effort.

This benefits UCCs by helping them get properly reimbursed while minimizing denials resulting from the incorrect association of diagnosis and procedure codes.

Manage your revenue cycle with Exdion Health

Exdion’s Revenue Cycle Management solutions help capture revenue comprehensively. Our solutions enable UCCs to collect healthcare payments, helping them to become more profitable. Smart medical coding solutions such as Exdion Health can enable faster turnaround times, efficiency, cost-effectiveness while boosting revenues. Get in touch with us to learn more about Smart Coding and Exdion’s Revenue Cycle Management solutions.

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