Practice Management
For consumers with high deductible health plans—which have become the rule these days rather than the exception—cash-pay options have become more attractive. In some cases, cash pay is actually a better price than the insurer’s negotiated rate, so it makes sense for a consumer who is paying out-of-pocket regardless to skip their insurance altogether. The only downside would be the fact that the direct, out-of-pocket expenditure would not be applied to the threshold of the …
Read More
While it may be premature to call the upcoming months “COVID season,” it’s a fact that case and hospitalization rates are starting to climb in multiple U.S. states. As such, it’s a good time to reconsider the importance of keeping your coding on point. The consequences of getting it wrong could result in underpayment—clearly not good for any business—but the consequences could be far worse if improper coding results in patients and payers being billed …
Read More
Normal procedures are anything but in the era of COVID-19. So, it’s imperative to ensure that all staff members are aware of the special circumstances surrounding billing for services related to the pandemic. Patients expect (correctly) that they can get vaccinated or tested without incurring any out-of-pocket expenses. Consequently, it came as quite a surprise when a patient in the Norcross, GA area stopped into an urgent care center to be tested for COVID-19—only to …
Read More
As we’ve told you recently, weeks- (or even months-) long waits for primary care appointments are forcing more patients to consider whether a trip to urgent care for ongoing concerns would be a wiser choice. With senior citizens among them, it would also be wise for you to consider whether you’re on point with optimal coding practices for cognitive assessments—which are required by the Centers for Medicare and Medicaid Services at annual wellness visits for …
Read More
With no one being infallible, mistakes are going to happen. While some that occur in the field of medicine have lifelong consequences, most are minor, easily fixed, and soon forgotten. Unless they’re so colossal that they make national headlines, like the case of a Texas man who went to the wrong freestanding emergency room for a test after being exposed to COVID-19 and wound up getting socked with a bill for $56,384. As reported by …
Read More
U.S. media reports in the early weeks of the COVID-19 pandemic drove many worried citizens to seek care (or even just testing) wherever they could, without regard to whether it was the best setting for their situation. Months later, as billing is catching up, it’s time to pay the piper—and some of the bills are far higher than patients may have expected. As we’ve seen historically, a good number are associated with freestanding emergency rooms. …
Read More
If COVID-19 has taken frontline clinicians and public health experts by surprise, you can be sure the same is true of billing and coding professionals. JUCM has brought you updates as often as possible (see The Impact of Public Health Emergency on Revenue Cycle Management by Monte Sandler, executive vice president, revenue cycle management for Experity, for example), but as the situation evolves so must your approach. So, Experity and the Urgent Care Association collaborated …
Read More
Our collective understanding of COVID-19 changes several times a day—as do procedures to ensure your urgent care operation receives the proper reimbursement for the indispensable services you provide. Just last week Experity released what was then new information on proper coding procedures; it’s outdated already, so the company has issued an update. Review it on the JUCM website to ensure you’ll be compensated fully and as efficiently as possible.
Read MoreCOVID-19 has been officially declared a pandemic, and school districts, sporting events, and cultural traditions like St. Patrick’s Day parades are being canceled in order to lower the risk of transmission among large throngs of people. One thing that goes on, however, is the day-to-day operation of the urgent care center—the only difference being that your work is more essential than ever. Secondary to that, of course, is the need to be properly reimbursed for …
Read More
The Medicare Payment Advisory Commission’s unanimous recommendation that Congress do away with “incident-to” billing could have a strong effect on physician assistants and nurse practitioners—and therefore, considering the growing role PAs and NPs play in this setting, on urgent care overall. If incident-to billing is eliminated, PAs and NPs will have to bill independently and at a lower reimbursement rate than they do now. Currently, the services of PAs and NPs who are truly assisting …
Read More