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Navigating Payer Reviews and Medical Decision-Making: A Critical Guide for Urgent Care Clinics 

Urgent care operators face increasing challenges from payer reviews, a situation exacerbated by ongoing confusion around coding guidelines and proper...

Unleashing Revenue Potential: A Guide to Credentialing and Billing in Urgent Care

In urgent care, effective credentialing and billing are not mere administrative tasks — they are pivotal components in driving revenue...

How to Avoid the Top 5 Mistakes in Contracting and Credentialing

Proper contracting and credentialing in urgent care is not easy, especially for clinics who don’t have an expert working with...

4 Habits to Start Today for Improved RCM in Urgent Care

Effective revenue cycle management (RCM) is the backbone of any successful urgent care operation. In our experience at Experity —...

Refresher: Guidelines for E/M Coding  

Hard to believe that the new E/M guidelines have been in place for urgent care for four years.  These guidelines...

Feb Industry Notes: Medicare Updated MBIs/Member IDs Causing Rejections 

According to a CMS press release, a security vulnerability in the MOVEit software used by Wisconsin Physicians Service Insurance Corporation (WPS)...

How To Register a Medicare Beneficiary  

At the end of every year, Medicare beneficiaries pick the insurance they want for the next year at open enrollment....

What’s New in Telemedicine for 2025? 

The American Medical Association (AMA) added a Telemedicine Services category to the Evaluation and Management section of CPT. Codes are...

How Does Data Reviewed Work When Coding E/M? 

Amount and/or Complexity of Data to Be Reviewed and Analyzed is one of three elements that determine the level for...

The Quandary of Opening an Urgent Care Without Contracts 

Alan A. Ayers, MBA, MAcc is President of Urgent Care Consultants and is Senior Editor of The Journal of Urgent...

Navigating the Complexities of Contracting and Credentialing in Urgent Care

Contracting and credentialing providers is a complex process that keeps evolving for urgent care. The number of payers involved, rules...

Navigating Diagnosis Denials

RCM Operations Director: Brianna Crowley A growing concern in the healthcare system is the increased amount of diagnosis denials. Insurance...

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