Journal of Urgent Care Medicine

The Challenges of Billing Out-of-Network

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC One of the biggest challenges for an urgent care is billing insurance as a non-participating provider. When opening a new practice or adding a clinic, completed credentialing and contracting is essential and has a direct impact on the overall success for a new business. Opening without effective dates may result in cash flow shortages due to the fact that most health plans will not offer retroactive effective dates. Additionally, …

ICD-10-CM: What’s New for 2024

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC, is RCM Compliance Manager, Experity With the fall season comes all the coding changes for the year. This starts with the 2024 edition of the ICD-10-CM codes, which went into effect on October 1, 2023. As a reminder, there is no grace period. Changes are effective on dates of service as of October 1. Prior to this date, practices should continue to use the 2023 ICD-10-CM code set. This …