StuWilli, Author at Journal of Urgent Care Medicine

Maximizing Reimbursement for Services on Campus, off Campus, or on the Phone

Q: We are coding for an urgent care group that is owned by a hospital and bills on a CMS-1500 for professional services and the UB-04 for facility services. We bill using Place of Service (POS) code 22. Is this correct? A: Prior to January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) POS code set did not differentiate between an urgent care operating on campus or off campus. As of January 1, …

An Uncommon Mechanism of Work-Related Partial-Thickness Triceps Tear

Urgent message: Triceps tears are an uncommon acute injury that can occur from multiple mechanisms, including direct trauma. Assessment of these injuries requires obtaining a medical history and exam and a knowledge of characteristic diagnostic imaging findings. Early diagnosis and identification in patients presenting to an urgent care center is critical to ensure that appropriate treatment is initiated in a timely fashion. Introduction Triceps tendon (TT) tear is the least common of all tendon injuries …

Occ Med Providers Be Warned: Urine Drug Tests Are Easy to Cheat

The ongoing surge in misuse of, and addiction to, opioid pain medications increases the appeal of worker drug testing to many employers, as well as to the federal government. In fact, it’s a cornerstone of efforts to identify people who use opioids inappropriately so they can get help before a tragedy occurs. Since urine tests work and are relatively inexpensive, they’re often employed by urgent care providers who offer occupational medicine services. The problem is …

Direct Care Supports Scaled Down Operations

As you’ve read here, the spectrum of business models accessible to urgent care operators is constantly expanding. “Direct care,” in which patients pay a monthly fee for a range of basic services, is one that may appeal to operators and clinicians desiring a less-structured approach to running their business—such as getting insurance companies “out of the room,” as explained by Linnea Meyer, MD in an article published in The Wall Street Journal recently. Patients pay …

Don’t Overlook Grants as a Possible Source for Funding

Urban—or in this case, rural—development can reinvigorate dormant local economies and bring hope to depressed communities. The associated investment can also be a source of funds for new or expanding urgent care businesses, if operators pick their spots judiciously. Urgent Care of Mountain View-Newton (North Carolina) is the beneficiary of a $70,000 grant from the state Rural Infrastructure Authority that will go toward renovating a Catawba County building that’s been vacant for 2 years, with …

Glass in Foot

Case The patient is an 8-year-old boy with pain in the right foot for the last several hours. He refuses to walk on the foot. There is no reported injury. On physical exam, you find there is a normal appearance to the foot (no erythema, swelling). However, there is pain with palpation over the plantar aspect of the mid aspect of the right foot. View the image taken (Figure 1) and consider what your diagnosis …

Report is a Wakeup Call to Beef Up Data Security

About a quarter of all healthcare consumers have been the victims of healthcare data breaches, according to a new study by Accenture—and nearly have of those people ended up victims of medical identity theft. The cost? On average, $2,500 in out-of-pocket costs per incident, paid by the victim. Breaches were most likely to occur in hospitals, though urgent care centers, pharmacies, physician offices, and health insurers were also fertile ground for hackers and identity thieves. …

UCA Asks Price to Delay New EHR Requirements

The Urgent Care Association (UCA) has petitioned Secretary of Health and Human Services Tom Price, MD to delay implementation of Stage 3 of the Meaningful Use program, as well as “Stage 3-like” measures in the MIPS program, indefinitely. UCA joined with 15 other organizations in crafting a letter that also requested that eligible clinicians not be required to move to EHR technology certified to the 2015 edition. Release of proposed requirements for MIPS and APMs …

Is a Single-Payer System Next for California?

While previous attempts have crashed and burned, proposed new legislation could move California one step closer to a single-payer healthcare system. Proponents in the state senate say it is the “intent of the Legislature” to enact such a law “for the benefit of everyone in the state.” However, specific details and a prospective timetable have not been revealed. If it does pass and ultimately get signed into law, the measure would replace private insurance in …

Membership Has Its Privileges—Affordable, Quality Care Being One

CareNow, a division of Hospital Corporation of America operating 26 centers in the Dallas/Ft. Worth area, has a membership program for patients without insurance. It appeals particularly to patients with high-deductible health plans who will be responsible, out of pocket, for the costs of their urgent care visits and thus choose to not use their insurance. CareNow charges $18/month for the membership and $68 for sick visits with the membership. Complex procedures, such as incision & …