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Wiki Urgent care center

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fami

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Santa Monica, CA
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Hello All,

I have to assist a physician who just recently open an urgent care center. His biller is a certified coder, but 80% of his claims are returned / rejected / denied.

Is any one have any information regarding billing for urgent care center?
Some of his patients are returning to him as follow up care, they are not a new patient anymore.

Thanks,
Fami
 
80% is a terrible rejection percentage. Have you noticed any one recurrent reason? There must be something or a couple of somethings that is being submitted incorrect every time. As far as new or established I would expect him to have a large number of established patients as an urgent care. What is being submitted as the place of service?
 
If he just opened I wonder if there are some credentialling issues as well.

Laura, CPC, CPMA, CEMC
 
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