RCM tip of the day: Achieving effective revenue cycle practices in urgent care


Urgent care facilities have various factors contributing to their financial performance. With the start of a new year, one factor they should focus on is achieving effective revenue cycle practices, according to Monte Sandler, executive vice president of revenue cycle management at DocuTAP.

First, Mr. Sandler encouraged urgent care facilities to look at patient registration.

"Though it can be challenging in many ways, the good news is that with focus on training and oversight during patient registration, you have control over your revenue cycle. The patient experience is critical in the urgent care setting, so … be sure you put the right staff in place to oversee this important and high-profile position," he shared with Becker's Hospital Review.

"Then, require they be trained — not just on how to greet patients —but also on tasks like verifying insurance coverage to make sure they have active coverage with a plan your clinic contracts with. Using real-time verification, you'll not only verify coverage, but can determine patient responsibility from the outset, and require payment before the patient leaves the clinic. As more of the responsibility is shifted to the patient, it is becoming increasingly important to collect at the time of the visit. And storing the patient's credit card information on file with appropriate authorization can cut down significantly on the time and energy required during the billing and collection process."

Mr. Sandler also discussed the importance of accurate coding, "from patient registration and charting to evaluation and management coding."

"Incorrect or incomplete documentation habits lead to poor coding; undercoding results in a loss of revenue, and upcoding can initiate audits. As a result, it's important to leverage business intelligence and reporting tools that can analyze billing trends to avoid critical mistakes," he says.

Finally, he encouraged urgent care facilities to avoid claim denials by ensuring staff is using correct current procedural terminology codes and modifiers.

"Once billing is complete, following up on delayed and denied claims must be a priority," Mr. Sandler says. "Although it does require time to review and refile, your revenue depends on managing all unpaid claims promptly."

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 


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