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Mistake #15 — Choosing an Inexperienced Person to do Billing

If you think it’s expensive to hire a professional to do the job, wait until you hire an amateur.
— Red Adair

Very rarely can one afford to hire an experienced biller for the new startup. In the past, I often recommended hiring a good staffer and together learning the ins and outs of billing. Over the years, however, I have seen new urgent care centers struggle and lose substantial revenue; the new centers seemed more likely to be tangled in the ropes of medical billing than to have learned the ropes of medical billing.

Doing billing yourself is a difficult and risky business. By the time you and/or your staffer realize you cannot do urgent care billing effectively, you are likely to have lost more money than you can afford. Medical billing is extraordinarily complex and gets more complex with every passing year. What’s more, urgent care is one of the most difficult specialties to bill.

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To start, someone in your new urgent care will need to know (or learn) all of the generic billing rules, such as where each payer wants the physician number, the practice number and which point-of-service code the payer will recognize. This by itself usually takes two to three months to sort out. Meanwhile you are not getting paid a penny for your services. Beyond the generic billing rules are the extraordinarily complex issues of billing for the multiple specialties covered in an urgent care practice. These specialties include primary care, orthopedics, occupational medicine, sports medicine, emergency medicine, neurology, and others.

What’s more, the critical nature of billing and its effect on cash flow will distract you early on from what you should be focusing on—growing your new urgent care center. Early on, you will need to concentrate on hiring staff, marketing your new center, convincing the local hospital you are not the enemy, educating the public about the value of your center, developing relationships with executives in local corporations, and—most importantly—delivering excellent patient care. If you are a typical new urgent care entrepreneur, you may be too busy to learn the ins and outs of urgent care billing. Maybe finding a billing company with urgent care expertise makes sense.