bnapolitano, Author at Journal of Urgent Care Medicine

The Incidentals of ‘Incident-to’ Billing

Q: I plan to hire physician assistants and other nonphysician providers in my urgent care clinic. I understand that I can use “incident to” billing to have their patient visits reimbursed at the physician rate. What are the rules for “incident-to” billing? A: The Centers for Medicare and Medicaid Services (CMS) defines “incident to” as “those services that are furnished incident to physician professional services in the physician’s office (whether located in a separate office …

Cardiopulmonary Emergency Masquerading as Gastrointestinal Symptoms

Nihar B. Gala, MD Urgent message: The ability to distinguish between urgent and truly emergent conditions is an essential skill for all urgent care providers. That distinction is especially challenging when symptoms could indicate either a relatively benign diagnosis that is well within the purview of the urgent care setting or a more dire diagnosis better suited for a higher-acuity setting. Introduction “Familiar” symptoms such as vomiting, diarrhea, and abdominal pain could be due to …

The Importance and Validity of Nondisclosure and Nonsolicitation Clauses for Urgent Care Center Owners

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: Nondisclosure and nonsolicitation clauses are necessary to protect an urgent care center from providers and staff utilizing information gained in their employment in ways that may be damaging to the business, but to be effective, their restrictions and limitations must be understood. Businesses frequently rely upon important …

Tattoos and Piercings: What the Urgent Care Provider Needs to Know

Urgent message: Tattoos and piercings are becoming commonplace, but patients who experience complications with these forms of body art may present to urgent care centers, as access to dermatology and plastics specialists frequently requires a referral or extended wait periods. The urgent care provider should possess a working knowledge about how tattoos and piercings are performed, how to recognize the complications, and how to treat them appropriately. Tracey Quail Davidoff, MD TATTOOS Introduction The term …

A Snapshot of Flu Vaccination Rates

The ongoing 2017–18 flu season is already one of the worst in recent memory. Recently released data from the Centers for Disease Control and Prevention may offer a clue as to one reason: Based on a complete study of the 2016–17 season, the CDC conjectures that influenza immunization rates may have plateaued. During that most recently completed season, just 46.8% of patients age 6 months or older got a flu shot—an increase of just 1.2% …

Don’t Celebrate the ‘End’ of Flu Season Before the Second Act

The Centers for Disease Control and Prevention may have spoken too soon when it declared the 2017–2018 influenza season to be on the wane. Now the agency says cases are mounting—though right now it’s influenza B, not the H3N2, A strain that is both more severe and less receptive to vaccines. In fact, with the week ending March 17 influenza B has usurped influenza A as the most dominant strain of the moment. It’s not …

Update: Ascension, Providence Call Off Proposed Merger

Just days ago, we told you that Ascension had plans to downscale its footprint, focusing less on its identity as a large hospital system in favor of more emphasis on broader community access and patient-driven care. Now the company is demonstrating that ethos by stepping back from its plans to merge with Providence St. Joseph Health, according to the Wall Street Journal. That deal would have made the combined company the largest hospital provider in …

UCA Advocates for Urgent Care in Comments on FDA CLIA Draft Guidance

The Urgent Care Association is one of numerous organizations that have filed comments regarding a draft Food and Drug Administration Guidance on CLIA-waived tests. UCA, and others, charge that the spirit of Select Updates for Recommendations for Clinical Laboratory Improvement Amendments of 1988 (CLIA) Waiver Applications for Manufacturers of In Vitro Diagnostic Devices runs counter to the intent expressed by Congress in passing the amendment. For one thing, they maintain, the FDA must remove proposed discussion …

News Flash: Patients Hate to Wait—and That Matters When Choosing a Provider

Nearly a third of patients taking part in a survey from Vitals say they’ve walked out on a physician appointment because they had to wait so long—and 20% have been so put off by wait times that they’ve switched doctors altogether. No surprise, then, that the Wait Time Report also reveals that 84% of people believe the amount of time they have to wait to see a medical provider is either “somewhat important” or “very …

Florida Joins States that Limit Opioid Prescriptions

Florida Gov. Rick Scott just signed new legislation into effect limiting the amount of opioid pain relievers physicians can write at one time. As other states have done, and as has been discussed at the federal level, the bill will limit opioid prescriptions for acute pain to a 3-day supply, though Florida prescribers will have the option of writing for a 7-day supply if medically necessary. The law will require prescribers to check the state’s …