Most healthcare operators think about coding as a back-office problem. Something to fix later, when there's more time, more bandwidth, more budget. The irony is that "later" is almost always the worst possible moment to act.
Here's the pattern we see over and over: a practice or urgent care group has a strong fall and winter. Volume is up. Providers are busy. The schedule is packed. And then Q1 arrives and the revenue doesn't match the story. Reimbursements are lower than expected. Revenue per visit is flat or declining. And everyone is left wondering what happened.
What happened is coding. And the time to fix it was six months ago.
The seasonal reality nobody talks about
Primary care and urgent care follow a predictable revenue cycle, but the coding risk inside that cycle is counterintuitive.
For urgent care, fall and winter are the money seasons. Flu, strep, COVID, RSV, volume spikes and sites run at full capacity. But high volume and rushed encounters are exactly when coding breaks down. E/M levels get underleveled. Procedure codes get missed. Labs and imaging reads don't make it onto the claim. By the time spring arrives and the revenue gap surfaces, the season is already over.
Primary care feels it differently but ends up in the same place. Deductibles reset in January, patient hesitancy climbs, and collections slow down, just as practices are trying to close the books on a busy fall. If coding accuracy wasn't where it should have been during the high-volume stretch, there's no recovering those dollars later.
The pain is felt in the slow season. The problem was created in the busy one.
This is why summer is the most strategically important window in the revenue cycle calendar. It's the only time of year when operators have the breathing room to look at what actually happened, understand the gap, and fix it before it repeats.
Undercoding is a system problem, not a provider problem
The instinct is to treat coding inaccuracy as a training issue. Run a session, update the guidelines, move on. But for multi-site organizations, undercoding is structural.
Different sites have different providers. Different providers have different habits. Without a systematic review process, there's no consistent standard, and the variance compounds with every location you add. A single practice leaving money on a visit is a rounding error. Across ten sites doing hundreds of visits a day, it's a meaningful revenue gap that shows up directly in EBITDA.
The other problem with the training-session approach: it addresses future visits, not past ones. Every undercoded encounter from last winter is already closed. That revenue is gone. The only way to change the outcome of the next high-volume season is to understand what went wrong in the last one, and build a review process that catches it in real time.
The pre-season window
Think of summer the way a sports team thinks about preseason. It's not the time to perform; it's the time to prepare. To identify the gaps, fix the fundamentals, and build the systems that make peak season execution possible.
For healthcare operators, that means:
- Benchmarking your current coding distribution against where it should be.
- Understanding which sites and which providers are driving the variance.
- Getting corrected codes into your EHR and feedback to your providers.
- Building a review process that runs automatically during high-volume season, when no one has time to think about it manually.
Groups that do this work in summer go into fall ready. Groups that wait discover the problem in January, when it's too late to do anything about the revenue they just lost.
The window is shorter than it feels
Fall comes fast. Implementation takes time. And the slow season, when cash flow is already tight, is also when budgets feel most constrained.
The good news: this is exactly the kind of investment that can be structured to fit the slow season. The financial impact shows up before Q4, which means the ROI is visible before the year closes. And the operational lift of getting it in place now is a fraction of what it would cost to try to fix a coding problem while running at full capacity.
You already know last winter's revenue didn't fully reflect last winter's volume. The question is whether you want the same outcome next year - or a different one.
