Home Specialities Urgent Care
15k–30k walk-ins/yr
the volume you run
Occ-med ready
Workers' Comp done right
Procedures & rapid labs
captured, not bundled
Real-time yield
not month-end guesswork
Busy every shift — and still leaving money at the door.
The number that decides urgent-care profitability isn't volume — it's Revenue per Patient Encounter: what you actually collect per walk-in. Two clinics can see the same 20,000 patients and finish the year a million dollars apart, purely on yield.
The gap comes from the quiet stuff: a 99214 downcoded to a 99213, a rapid test bundled for a missing QW modifier, a laceration repair charted but never charged, a Workers' Comp claim stuck 60 days behind a missing form. Each is small. Multiplied by your door count, they decide your margin.
Find your yield gapThe yield gap, per walk-in
Benchmark ranges, illustrative; the annual figure applies the bottom-to-top spread to a 20,000-encounter example. Your actual RPPE depends on payer mix, service mix, and charge capture.
Five numbers that decide whether volume becomes margin.
Here's how the top 20% of urgent cares run, versus the bottom 20%. Find the line where your clinic sits today — that's where the margin is hiding.
| Key performance indicator | Bottom 20% | National avg | Top 20% (elite) |
|---|---|---|---|
| Revenue per encounter (RPPE) | < $85 | $110 | > $135 |
| Payer E/M downcode rate | > 30% | 18% | < 6% |
| Workers' Comp first-pass yield | < 60% | 78% | > 92% |
| In-office procedure charge capture | < 75% | 88% | > 97% |
| Days in A/R (cash velocity) | > 48 | 32 | < 22 |
Benchmark figures compiled by OneMed for urgent care; treat as directional, not a guarantee. Your own numbers depend on payer mix, occ-med share, and workflow.
Workers' Comp is your best-paying line — and the one standard billing quietly breaks.
Occupational medicine can be 20–30% of an urgent care's revenue, and it pays well above standard commercial visits. But it's a different animal: state-specific forms, exact injury dates, employer and adjuster detail, pre-certification. Run it through the commercial queue — the way most billing teams do — and your most profitable claims auto-deny and sit in A/R for 60-plus days.
Pulled into its own workflow, that same revenue clears on the first pass. It's the fastest yield win most clinics have and never take.
- State-specific forms and filing rules
- Injury date, employer, and adjuster detail captured up front
- Pre-certification tracked before the claim drops
- Fee-schedule verification so comp pays what comp owes
What a dedicated occ-med workflow does
Illustrative of the improvement a dedicated occ-med workflow typically produces — not a guarantee. Actual results depend on state, employer, and payer.
Three quiet leaks the benchmarks don't show.
Even a clinic sitting at the national average is usually losing revenue in these three spots.
Modifier 25 with tests & procedures
When a visit also includes a rapid test or a laceration repair, the E/M is only separately billable with Modifier 25 and documentation that clearly separates the two. Miss it and the payer denies the E/M — or the procedure.
CLIA / QW lab bundling
Waived in-house tests (Flu, Strep, UA, Mono) need Modifier QW. Without it, the payer bundles the lab into the E/M and pays $0 — and across thousands of tests a year, that's pure profit gone.
Walk-outs & front-end capture
Left-without-being-seen, no-shows, and point-of-service copays leak daily when a high-turnover front desk rushes intake. A tight, consistent workflow keeps that revenue from walking out the door.
Real-time visibility, human coders, and a fight for every encounter.
We work inside your existing practice-management system — no EHR change, no disruption — and turn your walk-in volume into collected revenue.
Live scorecard visibility
Our ClearView dashboard shows your revenue per encounter, days in A/R, and downcode rate in real time — so a bad payer trend shows up this week, not at quarter-end, without changing how your staff works.
Downcode tracking & appeals
ClearView flags every visit a payer downcoded and the exact dollars lost; then our certified coders review the documentation and appeal where the medical decision-making supports the higher level.
Occ-med pipeline tracking
We run Workers' Comp in its own workflow and show exactly where each claim is stuck — pre-certification, employer information, forms — so your best-paying line stops aging in A/R.
Charge-capture gap closure
We reconcile documented procedures and rapid tests against what was actually billed, so a charted laceration repair or QW-eligible lab that never got charged is caught before the claim drops.
Who We Serve?
Throughput-and-yield billing for urgent care.
Independent urgent care
Single-site clinics that need every walk-in to yield its full, earned revenue.
Multi-site urgent care groups
Growing groups that need consistent yield, charge capture, and downcode defense across every location.
Occupational-medicine clinics
Clinics with heavy Workers' Comp volume that need a dedicated occ-med billing workflow, not the commercial queue.
Hybrid urgent + primary care
Blended practices juggling walk-in urgent care and longitudinal primary care under one roof.
Your claims data, handled properly
A BAA is executed before any claims data is shared, and everything is handled in a controlled, auditable environment.
Get your yield scorecard — and the 10 claims that prove it.
Pull 10 recent urgent care remits, redact the patient identifiers, and we'll benchmark your revenue per encounter and show the downcodes, bundled labs, and Modifier 25 misses live in 15 minutes — using your own data, without a bulk PHI upload.
- 1 · Pull 10 EOBs — a mix of established visits, rapid tests, and minor procedures from your top payer.
- 2 · Redact identifiers — names, DOB, and member IDs come out; we work from codes, modifiers, and amounts.
- 3 · Send securely — the redacted remits go into our secure portal before the call.
- 4 · Live reveal — where E/M was downcoded, Modifier 25 was erased, or a QW lab was bundled.
Book your yield scorecard
We'll confirm a time within one business day.
Common questions.
What is revenue per encounter (RPPE), and why does it matter?
It's total collected revenue divided by total encounters — what you actually collect per walk-in. Two clinics with identical volume can land far apart on RPPE, purely on how well they capture charges and defend their coding.
Do you handle Workers' Comp and occupational medicine?
Yes — in a dedicated workflow with state-specific forms, injury and employer detail, pre-certification, and adjuster follow-up, instead of the standard commercial queue that causes auto-denials.
How do you handle E/M downcodes?
Our ClearView dashboard flags every visit a payer downcoded and the exact dollars lost; then our certified coders review the documentation and appeal where the medical decision-making supports the higher level.
Can you fix missed in-office procedure and lab charges?
Yes. We reconcile documented procedures and rapid tests against what was actually billed, so a charted laceration repair or a QW-eligible lab that never got charged is caught before the claim drops.
Do you make us change our EHR?
No. We work inside your existing practice-management system and adapt to your workflow — no EHR change, no disruption.
What is the 10-claim reveal?
You pull 10 recent urgent care remits, redact the patient identifiers, and we benchmark your yield and show the downcodes, bundles, and modifier misses live in 15 minutes — without a bulk PHI upload.
Turn your walk-in volume into collected revenue
Book a 15-minute yield scorecard and see your revenue per encounter — and exactly where it's leaking — on your own claims.