Billing companies that work urgent care claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
Urgent care looks simple on paper. A patient walks in, gets seen, gets a strep swab and a prescription, and leaves in under an hour. Then the claim goes out at a low E/M level, the payer downcodes it anyway, and you realize the margin on that visit was thinner than the cost of working the denial. Volume is the business, so small leaks add up fast.
The problems repeat. Modifier 25 gets dropped when a visit includes a laceration repair, an injection, or a splint, and the E/M disappears. In-house x-ray and lab need the right technical and professional split, and the CLIA certificate has to match what you actually run. After-hours and weekend codes like 99051 pay under some contracts and nothing under others. Some commercial plans want one global visit code, others unbundle every supply, and a few Medicare Advantage plans follow rules of their own. Place of service 20 versus 11 changes payment, and every new site needs its own credentialing before the first claim. Then there is occupational medicine: employer accounts, workers comp carriers, drug screens, return-to-work forms, and invoices that look nothing like a normal claim.
In-house staff usually get the front end wrong first. Eligibility gets checked after the visit, copays get waived because the line was long, and self-pay quotes go unfollowed. A good urgent care biller tracks payment per visit type, not just the overall denial rate, and can tell you which payer quietly stopped paying for the 99051 you have been billing for two years. Outsourcing makes sense when you are adding a second or third site, or when your one experienced coder just gave notice. It also makes sense once accounts receivable has drifted past ninety days and nobody owns the follow-up. It is a poor fit if you want someone to only code charts and leave the rest alone. In the form, give us how many locations you run, your EHR, rough daily visits, and how much of your volume is occupational medicine.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals