Understanding Co-Pay Liabilities in Urgent Care Billing

Urgent Care Billing

Important aspects of Urgent Care billing

Urgent Care billing, or billing for services obtained at an Urgent Care facility, can sometimes spring a surprise on the patient. In spite of having healthcare insurance, it is often seen that a typical bill containing a component which needs to be paid by the patient. This is not an aberration, but rather the rule. Strictly speaking, insurance plans seldom provide complete 100% coverage. There is, in most cases, a part of the bill that they will not pay for. It is for the patient to pay and is known as deductible, co-pay or a co-insurance payment.

The amount of co-pay, however, varies widely from plan to plan and from one insurance company to another. It is also related to the specific benefits provided under a specific plan. Another important factor that determines how much a patient would be required to pay out-of-pocket is the inclusion of the Urgent Care facility in the insurance company’s network of ‘trusted’ facilities. While most Health Plans will still pay for services received at an Urgent Care facility not included in their network, the coverage benefits could be reduced and the co-pay may get higher.

Eliminating confusion with specialized assistance

Checking the patient’s eligibility for coverage, billing and coding for various services, collecting payment from insurance companies, answering questions about co-pays from patients who have received their bills, following up on delayed payments – Urgent Care billing is a demanding affair. It can keep the billing personnel tied to their desks for long hours, and distract a practice from attending to the patients. In order to reduce such hassles and implement a more streamlined billing process, many Urgent Care facilities engage extra assistance. This is done by outsourcing their billing matters to dedicated and specialized Urgent Care billing companies.

The benefits of such a strategic move are many. For one, it helps in improving the efficiency of the entire billing cycle. Denials get reduced, co-pays are collected on time, full collection is ensured and bills get paid quickly. Besides this, it also brings about remarkable savings in a facility’s operational cost. Urgent Care facilities looking for billing assistance can get access to trained resources at very competitive rates. In the midst of the current labor shortage and rising minimum wages, this is a lucrative prospect for any Urgent Care facility.


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