Urgent Care & Telemedicine
With the rising demand for urgent care and telemedicine services, providers face unique billing challenges. From high patient volumes to changing telehealth regulations, ensuring accurate and timely reimbursement is crucial. At Malakos Healthcare Solutions, we specialize in streamlining urgent care and telemedicine billing to maximize revenue and reduce claim denials.
Challenges in Urgent Care & Telemedicine Billing
1. High Volume, Quick Turnaround Billing
- Urgent care centers handle a large number of patients daily. Efficient billing is necessary to prevent revenue loss due to unbilled services or claim rejections.
2. Complex Coding for Telemedicine Visits
- Place of Service (POS) codes must be accurate to indicate whether the visit was virtual or in-person.
- Modifiers (-95, -GT) are required to show telehealth eligibility for insurance reimbursement.
3. Insurance Variability for Telehealth Services
- Medicare, Medicaid, and private payers have different reimbursement policies.
- Some insurers only cover telehealth under specific conditions (e.g., established patient relationships).
4. Coding & Documentation Issues
- Urgent care billing often involves E/M coding, lab tests, and minor procedures, all requiring precise coding.
- Incorrect usage of ICD-10 codes can lead to claim denials.
Best Practices for Successful Billing
1.Accurate Use of Telehealth Billing Codes
- Use CPT codes like 99441-99443 (telephone E/M services) and G2012 (virtual check-ins).
- Apply Place of Service (POS) 02 or 10 for telehealth visits.
2.Verify Insurance & Patient Eligibility
- Check coverage before appointments to avoid billing surprises.
- Obtain prior authorizations for treatments requiring approvals.
3. Efficient Documentation & Coding
- Use correct E/M levels for urgent care visits based on complexity.
- Document time-based billing for telemedicine consultations.
4. Reduce Claim Denials & Rejections
- Conduct pre-claim audits to catch coding errors.
- Implement a denial management strategy to appeal rejected claims quickly.
How Malakos Healthcare Solutions Can Help
At Malakos Healthcare Solutions, we specialize in:
- Urgent Care Billing – Faster claim processing & reduced denials.
- Telemedicine Reimbursements – Compliance with insurance policies & regulations.
- End-to-End RCM Support – From insurance verification to denial management.
- HIPAA-Compliant Billing – Ensuring telehealth & urgent care compliance with payer rules.