Explore how manual insurance verification leads to significant losses for urgent care centers and how automation can improve efficiency and patient satisfaction.
Manual insurance verification is costing urgent care centers time, money, and patient satisfaction. Here's why it’s a problem and what automation can fix:
Switching to automation saves 14 minutes per transaction, reduces errors, and improves payment collection. Tools like MedOps can cut administrative costs by 15–30%, resolve eligibility issues, and boost revenue while freeing up staff to focus on patient care. Delaying automation only increases these hidden costs.
Manual insurance verification often slows down operations in urgent care centers, leading to unnecessary costs that impact efficiency, revenue, and patient satisfaction.
Every insurance verification takes an average of 12.6 minutes, adding up to 8.4 hours a day for a center handling 40 patients. Staff spend this time making phone calls, navigating different online portals, and completing paperwork. Maria Rogers, Business Office Director at Pinnacle Medical Group, highlights the burden:
"A large part of our staff's day is spent on insurance verification"
It's no surprise that 70% of office managers report spending over an hour daily on this task.
Manual data entry often leads to mistakes, which can be expensive. Claim denials occur in 10-15% of cases, costing billions in lost revenue annually. Fixing and resubmitting a rejected claim can cost anywhere from $25 to $180. Kate Ankumah, Product Manager at Experian Health, explains the risks:
"If providers don't have a full picture of the patient's payable benefits, deductibles, co-pay thresholds, out-of-pocket maximums, and other policy details, they run the risk of non-reimbursement"
Incomplete insurance verification often limits payment collection to co-pays, leaving deductibles and co-insurance unaddressed. Research reveals that 56% of patients struggle to understand their insurance coverage without assistance from providers, and 61% want better explanations of their coverage. Additionally, 15% of providers identify eligibility issues as a top reason for claim denials. The financial toll is considerable: performing 1,250 manual eligibility checks annually can cost practices around $6,000. In the dental industry alone, manual verification costs reach approximately $835 million each year.
These inefficiencies drive up operational costs, as detailed in the next section on financial impacts.
Manual insurance verification brings both direct and indirect expenses that can heavily impact urgent care centers.
Handling insurance verification manually drives up labor expenses. Studies reveal that 15-30% of administrative costs in urgent care settings come from non-clinical tasks like these. During busy times, centers often need extra staff just to keep up with the verification workload.
Here’s how these costs add up:
These increased costs don’t just strain budgets - they also trickle down to affect the patient experience, which we’ll explore next.
The inefficiencies of manual processes don’t just cost money - they also frustrate patients. Recent data shows that patient collection rates have fallen to 48%, making it harder to maintain both positive relationships and reliable cash flow.
Patients often feel dissatisfied because of:
"Today's patients are shouldering more of their care costs than ever before, and high or unexpected outstanding balances can negatively impact both their experience and satisfaction." - Waystar
Adding to the issue, 30-40% of patients initially labeled as self-pay actually have insurance coverage. When verification falls short, urgent care centers miss out on significant revenue, further straining their ability to provide consistent, quality care.
Automation addresses inefficiencies in manual processes, streamlining operations and reducing costs in urgent care settings.
Automated systems eliminate the need for lengthy manual insurance checks, providing real-time coverage details. According to data, 70% of office managers report manual processes taking hours. RWJBarnabas Health showcases the benefits of automation:
"Staff no longer need to worry about making the wrong decision when choosing a plan, registration-related denials went down, and time was freed up for registration staff members to focus on more complex work that needed their attention." - Nicole Redwood, patient access director at RWJBarnabas Health
This approach not only saves time but also reduces labor costs while boosting financial performance.
Automation has also transformed payment collection processes. For example, UW Health achieved the following:
Clear and transparent cost estimates, which 90% of patients prioritize, play a significant role in these outcomes.
Automation minimizes errors and improves workflows by addressing issues like eligibility mistakes, which affect 20% of initial claims. It also prevents 65% of denied claims from being lost. UCHealth's experience highlights these benefits:
MedOps takes automation to the next level, helping urgent care centers cut costs and improve efficiency. Leveraging AI and smooth EHR integration, it removes manual bottlenecks and reduces operational expenses that can impact patient satisfaction. With the insurance verification market rapidly growing, MedOps stands out as a tool designed to simplify processes and save time.
MedOps addresses common challenges in insurance verification with a suite of practical features:
| Function | Benefit | Impact |
|---|---|---|
| Real-time Verification | Instantly validates insurance coverage | Cuts verification time by 86% |
| Batch Processing | Handles multiple verifications at once | Eliminates manual queue management |
| EHR Integration | Works with Epic, Cerner, Allscripts, Athena | Reduces screen switching and duplicate data entry |
| Pre-service Screening | Checks coverage 24–48 hours ahead of appointments | Flags issues before patients arrive |
By integrating directly with major EHR platforms, MedOps removes the need for extra logins and repetitive data entry, making the process much smoother.
The impact of MedOps is clear, with measurable improvements across urgent care operations:
Additionally, automated searches for missed coverage help prevent revenue loss. By reducing delays and minimizing manual tasks, MedOps frees up staff to focus more on patient care. It's a powerful example of how automation can transform urgent care operations, making them more efficient and cost-effective.
Manual insurance verification comes with steep hidden costs for urgent care centers. Eligibility errors are responsible for 75% of claim rejections, costing facilities between $50,000 and $250,000 for every 1% of rejected claims.
Automation offers a clear solution. Facilities that adopt revenue cycle automation see a 30% drop in claim denials. Automated systems also provide up to 86% faster access to patient information. These benefits align with the growing insurance eligibility verification market, projected to reach $11.4 billion by 2027.
The financial impact of sticking to manual processes is significant. Reworking claims costs between $25 and $180 per claim. Transitioning to automation not only reduces these costs but also minimizes errors and boosts efficiency. Tools like MedOps can streamline operations, saving time and money while improving patient satisfaction. Delaying automation only increases these avoidable expenses.
