Commercial Reimbursement In Urgent Care

Commercial Reimbursement In Urgent Care

While examining 17,410,492 commercially insured visits in the Experity EMR from November 1, 2024, through October 31, 2025, we calculated zero-balance net revenue per visit (NRV) for urgent care by state. NRV represents total payments from both patients and insurers when the claim is closed, and it includes evaluation/management and ancillary codes. Data include commercial plans and third‑party managed Medicaid and Medicare but exclude self-pay, workers’ compensation, employer-paid services, motor vehicle accidents, and traditional Medicare …

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Making a Business Case for Urgent Care Holiday Hours

Making a Business Case for Urgent Care Holiday Hours

 URGENT MESSAGE: Whether an urgent care center should be open 365 days per year or close on major or minor holidays depends upon factors that influence profitability, such as patient demand, competitive positioning, staff availability, payer reimbursement, and the branding impact of after-hours accessibility. Alan A. Ayers, MBA, MAcc is Practice Management Editor of The Journal of Urgent Care Medicine, serves on the Board of Directors of the Urgent Care Association, and is Vice President …

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