Practice Management
Urgent Message: Rural urgent care is the industry’s fastest growing segment, influenced by rural primary care shortages, hospital closures and extended ED wait times, but operational staffing and reimbursement complexities must be navigated. Alan A. Ayers, MBA, MAcc Citation: Ayers A. Rural Urgent Care Grows, But Challenges Remain. J Urgent Care Med. 2024; 19(3): 17-21 As access to care in rural areas continues to decline, urgent care (UC) can play a pivotal role in the …
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The percentage of urgent care visits involving a laceration procedure increased slightly from 0.75% in 2023 to 0.76% year-to-date in 2024, which is on-par with 2018 levels, according to Experity EMR analysis of more than 93.8 million urgent care visits, as of October 6, 2024. Over the past 15 years, the percentage of patients presenting with a laceration has gradually declined, attributed to a number of factors—chief among them being “case rate” reimbursement. Case rate …
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Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC Three elements determine the level for evaluation and management coding (E/M). “Amount and/or Complexity of Data to be Reviewed and Analyzed” is 1 of them and also the most confusing. Data Reviewed remained a point system after guidelines changed in 2021. As an auditor, I see both undercoding and overcoding in E/M caused by not applying the rules correctly. Let’s start with what tests count toward Data Reviewed. …
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Rajesh Geria, MD; Patrick O’Malley, MD Every year, our nation’s 14,000 urgent care (UC) clinics care for nearly 206 million patients, equating to 564,383 patients every day across the country.[1] Imagine what would happen if there was no urgent care for just a single day. Now imagine that if that possibility lasted not just a day, but indefinitely. Unfortunately, many communities are at risk for this reality coming to pass. Decreasing reimbursement, clinician burnout, and …
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Clarity is a good thing, but achieving clarity isn’t always easy. It requires a deep understanding, and reaching that depth takes time and energy. It’s taken us a few years. In 2022, we got clarity around the role of the Urgent Care Association (UCA). For a long time, we tried hard to do anything that anyone in Urgent Care needed, and that led to a lot of good work but also a very unclear identity. …
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We are deep into the fourth quarter of 2024, and you are probably preparing for the holidays and wrapping up year-end projects. As we celebrate the end of the year, it is important to also look ahead and lay the groundwork for revenue cycle management success in 2025. Following are some points to consider in your strategic plan for next year. Contract Renegotiations Understanding your payer agreements and your patient population will be instrumental to …
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Urgent Message: Urgent care centers need documented, consistent, and reportable processes for receiving, tracking, responding to, and collecting payment on subpoenas for patient medical records. Citation: Ayers A. How Should an Urgent Care Handle Requests for Medical Records by Subpoena? J Urgent Care Med. 2024; 19(2): 29-32 Alan A. Ayers, MBA, MAcc, is President of Urgent Care Consultants and is Senior Editor of The Journal of Urgent Care Medicine. Medical records are the critical foundation …
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As of September, 2024, there are a total of 14,245 urgent care centers in the United States, according to National Urgent Care Realty data. The charts above break down the footprint of urgent care centers by hospital affiliation, number of locations per operator, ages seen, and setting. From the data: 96% of urgent care centers treat all ages, whereas 4% specialize exclusively on pediatric populations 39% of urgent care centers are affiliated with a hospital …
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Urgent Message: Rapid growth in the autism spectrum disorder services (ASD) sector may present an expansion opportunity for urgent care operators who take the initiative to develop the necessary infrastructure. Citation: Ayers A. ASD Services Fit With Existing UC Business Models, J Urgent Care Med. 2024; 19 (1): 33-36 As the prevalence of autism spectrum disorder (ASD) continues to rise—now affecting 1 in 36 children in the United States—demand for accessible services is greater than …
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Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC We are heading into fall, and fall starts with updates to the ICD-10-CM codes. The most recent changes went into effect on October 1, 2024. There is no grace period. Because ICD-10-CM codes are date-specific, claims prior to date of service October 1, 2024, need to use the codes for that time period, switching over to the update on the exact day. While ICD-10-CM codes are updated semi-annually, …
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