Urgent Care RCM: How To Maximize Revenue

Urgent Care RCM: How To Maximize Revenue

The market is becoming more and more competitive and for an Urgent Care clinic to stay profitable and continue to maintain a positive cash flow, the revenue needs to be keep increasing. The scope and perception of urgent care clinics has changed and with this change, as a practice owner/ administrator you will need to invest in new technology, counter rising rent, hire qualified staff and all this can start adding up pretty quickly. So there has to be a continued focus on revenue generation. Cosentus has put together the following 5 tips for you to maximize your revenue.

Move to a Front-end driven Revenue Cycle Process

The revenue cycle for an urgent care starts from when the patient shows up for their appointment. It is important to ensure a good reception and minimal wait time for all the patients. This also involves performing some of your typical back end functions on the front end. Verifying insurance eligibility real time, requesting pre- authorization if necessary. When these are done on the front end, it gives patients the opportunity to pre-pay, cuts down the collection cost & reduces exposure to bad debt. Some of the other things that you need to ensure to improve your revenue cycle performance are as below:

  • Ensure robust documentation for optimized E&M Coding. The difference in reimbursement from a low level to a higher level could be $35-50 for each level of code
  • Ensure ZERO charge leakage, to avoid loss of revenue. If the need be establish a charge reconciliation process
  • Ensure 99% clean claims submissions
  • Establish Electronic link for electronically submitting claims to the payer, this results in faster processing of claims and that means faster reimbursement too.
  • Move from claims denial management to prevention of denials for sustained cash-flow
  • Be quick and aggressive with your Accounts Receivable Follow up

Plan in advance for your end result!

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Negotiate Profitable Payer Contracts

Being contracted with local IPAs will not only result in more patients but timely and good reimbursement too. If you are contracted with IPAs in your area keep reviewing the fee schedule every two years and if you believe there is a need for increment in the fee schedule, start the re negotiation in a timely manner. The insurance takes time to finalize contract negotiation. When applying to a new payer for a contract please make a good case for yourself. Show the payer, the benefit of the benefit, in terms of how their patients will have a reliable and convenient treatment option at your clinic and also how that will mean lesser expense for the payer as compared to when the patient would have visited an ER. Try to contract with the national payers for increasing the patients at your center.

Add Additional Lines of Business

Once your Urgent Care has been in business for a year or two, you must start adding additional lines of business. Occ Med is a pretty smart choice, as it helps balance the workflow throughout the year. Work comp and other work-related medicine is not only a great source to add patients but also improves your worth in the community. Travel vaccine, Flu shots, sports medicine, concussion screening and providing DME is a profitable stream to consider for continued revenue. Research the local medical needs in your community and start catering to those, to improve revenue and improve your worth in the community as an alternate to other expensive treatment options. Always keep in mind for an Urgent Care to be fairly successful, it has to become a real alternative to the ER for where possible.

Boost Your Online Presence

Your website helps create perception so think of it as a location and use it to send attractive and inviting messages when people find you online. Please make sure your website is easy to navigate, has all the information about the services available and the physicians available. Your website needs to have proper links to online scheduling, social networks such as Facebook and review sites like Yelp. An integrated patient payment portal improves your chances of seamlessly collecting patient out of pocket dues. Also, you can use this patient portal to market the Flu shots and travel medicine etc. To summarize a good online presence means more patients and also allowing your patients to recommend you to others as well when they write good review or rate you well. It is a win-win

Engage and Retain Patients

Urgent Care clinics must provide a viable alternative to the primary care physicians and ER, for them to survive and succeed. One of the most important things you need to do is to make sure that the patients have the best healthcare experience when they come to your clinic. You got to make that memorable first impression for the patient to come again if they need urgent medical attention and also for them to recommend your clinic to friends and family.

To improve patient engagement and satisfaction you got to have an easy to use, online scheduling solution. The need of the hour is to make is easy for patients to set appointments conveniently and once the patient come in for their set appointment you need to ensure minimum wait time. If you anticipate delays, text the patients in advance. It tells them you value their time and that is always a good impression to make. After the appointment, send a basic and simple survey to the patient to gauge their overall satisfaction. Respond quickly when someone shows a disappointment or concern.

They key to sustained loyalty is building and nurturing a relationship with your patient. And it is this sustained loyal patient base that is going to earn you revenue for a long time to come.

Cosentus has helped several Urgent care centers to improve their revenue. We are experts at Optimizing your Billing for Maximized Collections. Talk to a Cosentus Revenue Cycle expert today to find out how you can Maximize your revenue.

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