Top 10 Tips to Improve Urgent Care RCM in 2024

Every healthcare organization must optimize its revenue cycle management (RCM) to ensure its financial health, and urgent care facilities are no exception. Considering the changes in the healthcare sector in the year 2024 and beyond, the strategies for urgent care RCM will have to be different to address issues. Such as formulating new policies, meeting patients’ needs, and developing technology. Good RCM practice guarantees that urgent care centers can create and sustain their cash flow without necessarily lowering the quality of services offered. Each aspect of their practices, from the appropriate coding and billing to the timely claims filing. Hazardous waste management practices will enhance their revenue cycle in many ways.

This post highlights the ten most significant Urgent Care RCM Improvement Ideas in 2024 that every practitioner shares with the patients. These recommendations aim to improve the billing cycle, reducing the chances of payment denial and perfect the processes in your office for better profitability and a steady growth curve.

Tips to Improve Urgent Care Revenue Cycle Management

Invest in Advanced Medical Billing Software

To enhance the urgent care RCM, the first step is to install a more sophisticated billing software system. The appropriate software can assist in eliminating manual processes for claims submission; posting payments, contacting patients, and many other activities, thus reducing errors and saving time. Many medical billing services include the most recent billing software that assists in correcting coding mistakes, which alerts the user about incomplete data and quickens the claim submission process. This helps ensure the urgent care center is not behind the billing deadlines and increases the functionality of its revenue cycle. 

Train Staff on Proper Coding and Billing Practices

It is crucial to code with precision to ensure timely payments and minimize claim rejections. Periodic refresher courses on appropriate coding and billing methods for your personnel are among the best measures for enhancing urgent care Revenue Cycle Management. Incorrect coding, including ICD-10 and CPT codes, has been identified as one of the main factors. This results in the decline of claims, which hampers revenue collection processes.

The presence of certified coders is crucial and should be done within the firm or by offering the services of a medical billing company so as to make sure that all claims are correctly coded. Periodic training courses are conducted to help equip your staff with information regarding any new developments in health care policy and billing procedures.

Implement Pre-Authorization and Eligibility Verification

An urgent care revenue cycle management (RCM) process is incomplete without third-party authorizations and insurance checks. Before rendering services, it is important to check if the patient's insurance is in force and provides for appropriate treatment. Otherwise, unclaimed bills may occur, leading to slow payments and inconveniences to the practice and the patients.

Most medical billing providers allow you to verify eligibility instantly. This helps ensure no waiting patients remain whose coverage has not been confirmed. These tools also prevent unpleasant surprises relating to deductibles and copays after the service has been rendered. Hence, clarity is provided from the start.

Enhance Patient Communication for Payment Collections

Communicating clearly and effectively with patients is vital for timely payments in any urgent care practice. It is common for patients to be unaware of their financial responsibilities, especially when it comes to information about deductibles or copays. More effective communication, especially concerning what is expected in terms of payment, helps to improve collections and reduce delinquent balances.

Also, allowing online payment, offering a payment plan, and accepting credit card payments enhances the bill settlement process for patients by providing more than one payment option. Medical billing services can help coordinate these payment channels and ensure that collections are done properly.

Track and Analyze Denied Claims

Claim rejections are unavoidable hardships organizations can manage by systematically observing and evaluating them to prevent future occurrences. When there are unpaid claims, it is important to understand why each claim has been denied. This is particularly important when looking at the absence of information, the possibility of error in coding, or even some questions regarding one’s eligibility.

Alternatively, finding and eliminating denial rates can be done with a cost-effective option of providing an in-house denial management program. Outsourcing denial management services to medical billing and coding practices will help your practice reprocess and resubmit claims that are at risk of not being paid upon submission, thus reducing the chances of reimbursement delays. Additionally, Analytics can be utilized to track the denial rate and remove the causes of repeat issues to increase the rate of payable claims.

Offer Self-Service Options for Patients

Many patients look forward to the introduction of digital means of managing their health care in 2024. Providing these patients with self-service portals in their facilities to view their bills, make payments, and change their insurance details will help improve the revenue cycle. 

Lastly, offering self-service solutions enhances the patient journey and eases the burden on your admin team. Many healthcare billing companies provide these portals, enabling patients to interact easily with the billing system.

Maintain Compliance with Healthcare Regulations

The healthcare landscape is dynamic as new regulations and changes to billing arise. Thus, compliance is very important to avoid being penalized or delayed in payments. Compliance plays an important role in the revenue cycle management of urgent care, from the HIPAA Act to Medicare guidelines. Ensuring your billing functions adhere to current regulations will save you from costly mistakes.

Nonetheless, a professional medical billing company can also help observe compliance simply because they are always aware of the industry's changes and ensure that your establishment implements the right coding, billing, and patient privacy policies.

Leverage Data Analytics to Improve Revenue Cycle Performance

Data analytics can monitor and enhance the financial results of your urgent care center, which is an important aspect today. The major aspect of data analytics is regularly reviewing some important KPIs covered in revenue cycle management, including the denial ratio, AR days, and claim approval time.

The sophisticated analytical tools that most medical billing solutions provide access to can help you make sound decisions based on your practice's financial performance, improving urgent care RCM management.

Outsource Medical Billing to Professionals

Most urgent care facilities embrace medical billing services to manage their revenue cycle. Outsourcing billing services facilitates a focus on patient care as professionals manage coding, claim filing, denial management, and debt collection, among other tasks unrelated to patient care.

Expert medical billing services can deliver timely and proper claim submissions as they have the required skills and infrastructure. They also provide services related to denied claims, patient billing, and compliance management that help enhance the overall efficiency of RCM activities.

Monitor Accounts Receivable (AR) Regularly

One of the most important variables for any urgent care facility is accounts receivable (AR). The company must monitor this indicator to check if claims are being submitted. It must ensure that payments are being processed and that any overdue claims could affect cash flow.

A prudent benchmark is keeping the number of AR days at or below 30. Such an outcome means the practice has successfully collected the payment. In such cases, medical billing providers offer AR management services, payment collection, and claim filing, among other services.

Conclusion

The advancement of urgent care revenue cycle management in 2024 will necessitate many aspects, such as automation, training, adherence, and data for decision-making. These ten tips, implemented by any urgent care center, will improve billing and decrease rejected claims. Most importantly, they will enhance billing collections. Engage a medical billing company to acquire the necessary skills and technology for effectively accomplishing complex billing processes.

If your urgent care facility implements the right measures. It can continuously enhance its revenue cycle while seeking to remain profitable in the changing sectors of health services.