Specialty
Urgent Care Billing and RCM
High volume, walk-in eligibility, and a payer mix that changes hour to hour.
Why it’s different
Urgent care has no scheduled book to verify against the night before. Patients arrive without appointments, often without their card, sometimes without knowing whether their plan is still active.
Volume is high and margin per visit is thin, so eligibility failures and E/M levelling errors compound faster here than in a scheduled practice.
Common challenges
Where the money goes missing.
- Walk-In Eligibility
- No schedule to verify in advance, so coverage is confirmed at or after the visit.
- S-Codes
- S9083 and S9088 accepted by some payers, rejected outright by others.
- Place of Service
- POS 20 versus 11 applied inconsistently across the same payer.
- E/M Levelling
- A very wide range of presenting problems levelled by habit rather than documentation.
- Same-Visit Procedures
- Procedures performed at the visit not captured alongside the E/M.
How we help
We run eligibility as fast as registration allows and re-check at posting, maintain payer-specific rules for S-codes and place of service, and reconcile procedures performed against the E/M billed.
We do not provide coders. Your clinical team assigns the codes. We verify and validate them.
Key codes
- CPT 99202–99215
- HCPCS S9083 / S9088
- Place of Service 20
- Modifier 25
Indicative, not exhaustive. Code sets and payer policies change.
Get an Urgent Care Billing Analysis
Send us a sample of your denials. We'll tell you what's actually driving them in your specialty.