Billing built for the pace of walk-in care
Fast-turnover visits, bundled procedure codes, and workers' comp claims don't fit a generic billing process. We code, submit, and collect on urgent care claims the way urgent care actually runs.
Urgent care claims break in their own, specific ways
General medical billing processes weren't built for unscheduled, multi-service, multi-payer visits. Here's where they typically fail.
High visit count, thin documentation
Providers move fast between patients, so coders must pull an accurate E/M level (99202–99215) from concise charts without under- or over-coding.
Bundled facility & capitation codes
Payers may require S9088 or the capitated S9083 alongside the visit code. Missing this is one of the most common reasons claims underpay.
X-rays, labs, and procedures on one claim
Imaging, rapid tests, wound repair, and splinting all ride alongside the E/M visit — each needing correct modifiers to avoid NCCI bundling denials.
Occupational health claims run separately
Employer referrals and workplace injuries follow their own fee schedules and documentation rules — distinct from commercial insurance entirely.
End-to-end urgent care billing services
Every stage of the claim lifecycle, managed by a team trained on urgent care coding and payer rules specifically.
Real-Time Eligibility Verification
Coverage, co-pay, and referral requirements checked at check-in — before an unverified visit becomes a denial.
E/M & Procedure Coding
Certified coders assign accurate ICD-10, CPT, and HCPCS codes with correct modifiers across every service on the encounter.
Charge Entry & Claim Submission
Clean claims submitted within 24–48 hours, following payer-specific rules for facility codes and place of service.
Denial Management
We track urgent-care-specific denial patterns — bundling edits, missing referrals, fee-schedule disputes — and fix the root cause.
Workers' Comp & Occupational Health
Employer-referral and workplace-injury claims billed separately, following the correct state fee schedule.
Payment Posting & Reconciliation
Payments posted promptly and matched against expected reimbursement so underpayments get caught, not written off.
A/R Follow-Up
Unpaid claims worked on a defined 30/60/90-day schedule so revenue doesn't age out of recoverability.
Patient Billing & Statements
Clear statements that reduce billing confusion and speed up patient-responsibility collection.
A tight, daily billing cycle — not a weekly batch
Six steps, run continuously, from the day we onboard your clinic.
Onboarding & system integration
We connect to your existing EHR/practice management system and review current fee schedules and payer contracts.
Baseline audit
Before taking over billing, we review recent claims and denials to find revenue leaks specific to your clinic.
Daily claims cycle
Charges are coded, entered, and submitted daily — keeping your billing cycle tight instead of batched weekly.
Quality review
A second-level coding and claims review catches errors before submission, not after a denial arrives.
Denial resolution & A/R follow-up
Denied and unpaid claims are worked on a set schedule rather than sitting in a queue.
Monthly reporting
A clear breakdown of collections, denial rates, days in A/R, and payer performance — every month.
Specialty focus, not a generalized billing curriculum
Urgent-care-trained coders. Trained specifically on the codes, modifiers, and payer rules that come up in walk-in care.
Compliance-first process. Built around HIPAA safeguards and current CMS and payer guidelines.
Full transparency. Monthly visibility into claims, denials, and collections — never a black box.
Current on code changes. Annual CPT/ICD-10 updates and payer policy shifts, tracked as they happen.
Every claim follows current coding and privacy standards
Coding and billing work follows HIPAA requirements for protected health information, current CMS guidelines, and NCCI edit standards.
HIPAA-aligned PHI handling
Current CMS coding guidelines
NCCI edit-aware claim review
Annual CPT/ICD-10 update tracking
Frequently asked questions
Does urgent care billing require different codes than a regular office visit?
Yes. Beyond standard E/M codes, many payers require an urgent care facility code (S9088) or a capitated code (S9083) in addition to the visit code. Missing this is one of the most common causes of underpayment.
How do you handle claims for on-site X-rays and lab tests?
These are coded and billed alongside the E/M visit using the correct CPT codes, with modifiers applied where needed to prevent bundling or denial.
Can you bill workers' compensation and occupational health claims?
Yes. We handle workers' comp and employer-referral billing as a distinct process, following the applicable state fee schedule and documentation requirements.
How quickly are claims submitted after a patient visit?
Coded charges are typically entered and clean claims submitted within 24–48 hours of the visit, keeping your reimbursement cycle short.
Will we still have visibility into our billing performance?
Yes. You'll receive monthly reporting covering collections, denial rates, A/R aging, and payer-specific performance, with updates in between on request.
Let's find the gaps in your urgent care revenue cycle.
Book a free consultation — we'll review recent claims and denials and show you where reimbursement is being lost.