Health

Exploring the Costs of Urgent Care Lab and X-Ray Services

To promptly help patients, urgent care centers must offer lab and x-ray services. This sets them apart from other options like primary care and retail clinics. Centers with these services can treat a wider range of patients. Traditionally, these services bring in revenue under fee-for-service contracts. Payers pay based on CPT codes, often above Medicare rates. However, many insurers, including Medicare, are moving to flat reimbursements per visit, called “case rates.” Unless specified, this doesn’t consider service level or extra services like x-rays and labs. This may affect a center’s income if lab and x-rays aren’t exempted.

Financial Analysis of Urgent Care Lab & Radiology

Explore income, costs, and assumptions for lab and x-ray services, making informed financial decisions. 
  • Net Revenue: You might assume how many flat-rate visits include lab or x-ray. The center might not have seen them if they didn’t offer these services.
  • Supplies & Maintenance: Maintenance, parts, service agreements, and radiation monitoring are covered for X-rays. Labs include costs for tests, kits, and collections.
  • Equipment Costs: Piccolo machines and x-ray processors lose value over time. This cost includes financing and lease expenses for equipment you don’t own
  • Professional Services: Radiology Over-Read, Send-out Labs
  • Tech Salary & Benefits: Fees for X-rays cover payments to radiologists for extra readings, paid by the center. Lab fees include payments to reference labs for tests sent out, also paid by the center.
  • Overhead & IT Costs: When hiring lab or x-ray techs, their costs include hourly pay, overtime, vacation, taxes, insurance, and retirement. For other employees, we allocate costs based on time spent on x-ray and lab tasks.
  • Physician Time & Incentives: We can estimate how much space labs and x-rays use, divide utility costs fairly by square footage, and split billing and IT costs by collection percentage.
  • Direct vs. Indirect Revenue/Costs: Cutting X-ray and Lab Costs
  • Staff Management: Some states mandate radiologic technologists (RTs), but in others, medical assistants with basic x-ray certifications suffice, saving on salaries.
  • Flexibility: Physicians can take X-rays during slow periods, reducing staffing needs.
  • Cross-Training: RTs can learn other roles to stay productive. Lab techs, though rare, can also adapt for cost-efficiency

Manage Laboratory expenses

Urgent care centers conduct standard tests on-site (like pregnancy and strep tests) while sending complex tests to reference labs. Complex tests include cultures, blood counts, and more.  The urgent care center bills differently based on the payer. They might pay the lab fee. They need to know what they collect and pay in fees to make a profit. This helps avoid money-losing tests. Alternatively, the center might charge only for collecting samples. The reference lab bills patients or insurance directly for tests. Some insurers require samples to go to their lab, causing inconvenience and lost revenue for the center. This results in less profit and no control over lab prices, making it impossible to quote test prices to self-pay patients. Dissatisfied patients blame the center for reference lab billing issues. In this situation, picking any best medical billing services in New Jersey can help you lose revenue and save every penny you deserve. 

Create a clear X-ray over-read policy

The profitability of X-ray billing depends on over-read practices. Every immediate care in Algonquin or any part of the USA, with X-ray services, should have an over-read policy. This can vary from not using outside radiologists to selectively over-reading specific X-rays like those for non-extremities and children or over-reading all X-rays. Over-reads are usually for confirmation, not diagnosis. Billing options vary. The urgent care center and consulting radiologist have separate x-ray charges. The radiologist may get a fixed fee from urgent care for readings. In some cases, radiology is managed and billed by a radiology group, common in multi-specialty or hospital-run facilities. A policy covering or charging too much can hurt the center’s profit from X-ray services. This is crucial for diagnosis when quick readings are needed, as more providers will use them. It’s important to balance quality care, liability control, and cost-effectiveness in X-ray services.

Conclusion

Urgent care centers stand out with on-site lab and x-ray services, which are vital for patient care. These services must also be financially sustainable. With changes in payment models, covering lab and x-ray costs is challenging. To ensure sustainability, urgent care operators must grasp the economics. Analyzing their finances can guide staffing, practices, and provider use.

FAQs

Why are X-rays so expensive?

Equipment costs: X-ray machines and related equipment can be expensive to purchase and maintain. These costs are often passed on to patients through higher fees. Training and staffing: X-ray technicians and radiologists require specialized training and certification, which can be costly.

Ever wonder why it’s called X-ray?

In 1895, a German physicist named Wilhelm Roentgen found a strange radiation. He called it X-radiation because he didn’t understand it. This radiation could go through things that block regular light.

What’s the name of X-ray technology?

It’s called Radiologic Technology or Radiography. It’s all about using radiation to create images of the body.