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
Your clinic can be busy every shift and still leave money at the door.
The number that decides urgent care profitability is not volume. It is revenue per patient encounter, which means 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 where your clinic sits today. That is 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 often your best-paying line, but standard billing workflows can break it.
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. When Workers’ Comp claims are run through the commercial queue, they often deny automatically and sit in AR for more than 60 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
This shows the kind of improvement a dedicated occupational medicine workflow can produce. It is 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. If Modifier 25 is missed, the payer may deny the E/M visit or the procedure.
CLIA / QW lab bundling
Waived in-house tests (Flu, Strep, UA, Mono) need Modifier QW. Without the right lab handling, the payer may bundle the lab into the E/M visit and pay USD 0. Across thousands of tests a year, that becomes lost margin.
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 with no EHR change and no disruption, turning walk-in volume into collected revenue.
Live scorecard visibility
Our ClearView dashboard shows revenue per encounter, days in AR, and downcode rate in real time. A bad payer trend shows up this week, not at quarter end, and your staff does not need to change how they work.
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, including pre-certification, employer information, forms, and adjuster follow-up. Your best-paying line stops aging in AR.
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 will benchmark your revenue per encounter. We will show downcodes, bundled labs, and Modifier 25 misses in a live 15-minute review using your own data, without a bulk PHI upload.
- 1 · Pull 10 EOBs with a mix of established visits, rapid tests, and minor procedures from your top payer.
- 2 · Redact identifiers, including names, dates of birth, and member IDs. We work from codes, modifiers, and amounts.
- 3 · Send the redacted remits securely through our portal before the call.
- 4 · Review the results live to see where E/M was downcoded, Modifier 25 was missed, or a QW lab was bundled.
Request received.
Thank you. A member of our team will review your information and be in touch within one business day. We look forward to showing you what your practice should be collecting.
Common questions.
What is revenue per encounter (RPPE), and why does it matter?
Revenue per patient encounter is total collected revenue divided by total encounters. It shows 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. We handle Workers’ Comp in a dedicated workflow with state-specific forms, injury and employer details, pre-certification, and adjuster follow-up. This avoids the standard commercial queue that often causes automatic 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, with no EHR change and no disruption.
What is the 10-claim reveal?
You pull 10 recent urgent care remits, redact the patient identifiers, and we benchmark your yield. We show downcodes, bundles, and modifier misses in a live 15-minute review without a bulk PHI upload.
Turn your walk-in volume into collected revenue
Bring ten claims to a 15-minute review and see what was absorbed into the flat fee using your own numbers.