Question

You are the practice manager for a large urgent care (UC) practice. Lately, revenue coming in from billed visits has trended downward, despite the UC seeing increased volumes of sicker patients. You r

Answer 1

The decrease in revenue at the urgent care practice despite an increase in sicker patients can be attributed to factors such as insurance reimbursement rates, coding errors, and increased costs. To address this issue, the practice manager should analyze insurance contracts, ensure accurate coding, identify areas for cost reduction, and negotiate better reimbursement rates with insurance companies.

Step-by-step explanation:

The decrease in revenue despite an increase in sicker patients at the urgent care practice can be attributed to various factors:

1. Insurance reimbursement rates: It is possible that the insurance companies are reimbursing at lower rates for the same services, resulting in decreased revenue.
2. Coding errors: Inaccurate coding of the medical procedures and services provided could lead to lower reimbursements from insurance companies.
3. Increased costs: The practice may be incurring higher costs due to a rise in expenses such as supplies, equipment, or staffing, which could offset the revenue increase.

To address this issue, the practice manager should analyze insurance contracts, ensure accurate coding, identify areas where costs can be reduced, and consider negotiating better reimbursement rates with insurance companies.