Credentialing and Contracting: What to Expect When Expanding

For those trying to grow their urgent care business, conversations around payer contracting and credentialing (CC) can often be overwhelming and seem contradictory to the mission of On-Demand Care. Tammy Mallow, our resident Experity advisor on all things CC says she often finds herself being the perceived as a “dream killer” when educating owners to the inner workings of this process. Established groups often expect the payer rules to be the same as they were …

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Pitfalls of Point of Care Ultrasound (POCUS)—A Perspective

Pitfalls of Point of Care Ultrasound (POCUS)—A Perspective

Urgent message: Point-of-care ultrasound (POCUS) is well established as an imaging tool in the urgent care center. Although it is generally considered safe and easy to use, safety and hygiene considerations are frequently ignored—possibly leaving patients at risk for infection and excessive radiation exposure. Avijit Barai MBBS, MRCS, MSc, PgCertCPU, FRNZCUC; Martin Necas, MMedSonography, AMS, RDMS, MRT, RVT; and Bruce Lambie, MBBS, FACEM INTRODUCTION Point-of-care ultrasound (POCUS) is well established as an imaging tool in …

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Are There Any Restrictions on an Urgent Care Provider Charging a No-Show or Cancellation Fee?

Are There Any Restrictions on an Urgent Care Provider Charging a No-Show or Cancellation Fee?

Urgent message: When holding a time slot that could go to another paying customer, it’s common for service businesses to charge no-show or cancellation fees. With many urgent care centers moving to online registration and queuing systems, could this be a solution for maximizing throughput in urgent care as well? Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine. Please provide at …

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Is Specialization the Future of Urgent Care?

Urgent care has historically been viewed as a setting where patients could present with anything short of life- or limb-threatening complaints (though even those parameters have been stretched in dire situations.) And that identity has served the industry well, as evidenced by nearly constant growth over several decades. As time wore on, though, it became evident that there are business opportunities to be had by addressing niches with special needs. Occupational medicine is a prime …

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Last Minute Coding Changes for 2021

December brought us some last-minute coding changes. In some cases, this caused a small claim delay as clearinghouses and payers scrambled to update their systems. New ICD-10 Codes for COVID-19 Effective January 1, 2021, there are new ICD-10 codes for reporting COVID-19 related diagnoses. These codes replace the existing codes we are using that are not as specific. There are two other new codes:  81 (Multisystem inflammatory syndrome (MIS)); and 89 (Other specified systemic involvement …

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National Urgent Care Clinical Quality Metrics: ‘This is the Way’

National Urgent Care Clinical Quality Metrics: ‘This is the Way’

Every system is perfectly designed to get the results it gets. This quotation, commonly attributed to Dr. W. Edwards Deming,1 has never been more relevant for urgent care (UC) than right now. Considered the original guru of quality improvement, Dr. Deming was explaining why systems must be redesigned if the desired outcomes are not being achieved. The existing “system” for measuring clinical quality in UC needs an overhaul. It is fragmented and underdeveloped, and lacks …

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Liability of an Urgent Care Center for Third-Party Labs

Liability of an Urgent Care Center for Third-Party Labs

Urgent message: While an urgent care center is responsible for the collection and safeguarding of clinical specimens, it’s generally not liable for the activities of a third-party lab that it sends a specimen to. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives, Experity Urgent care facilities regularly provide bloodwork and laboratory testing for their patients. These services may include allergy screening, diabetes testing, anemia screening, immunity testing, thyroid screening and monitoring, and …

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Children Are Visiting Urgent Care in Growing Numbers—Is That Reflected in Your Practice?

JUCM has devoted a lot more space to covering aspects of providing urgent care for children. In this very issue there’s a new original research article on how long the SARS-CoV-2 virus lasts in children who may or may not be symptomatic (see page XX). And if you look at our Masthead, you’ll notice we’ve even engaged a pediatric urgent care provider to provide guidance and to help us ensure we’re conveying the right information …

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FAQ: New E/M Guidelines

It’s 2021, and the new E/M guidelines for office visit codes are here. Hopefully, providers will feel some relief in the amount they need to document and can spend more time treating their patients. This month I’ll answer some of the questions I’ve received.  Q. Do all three elements of medical decision-making (MDM) need to be at the same level for the code selected? A. No. Only the two highest elements need to be met …

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Adapting Urgent Care Marketing Strategies to Include Mobile and Voice Technologies

Adapting Urgent Care Marketing Strategies to Include Mobile and Voice Technologies

Urgent message: As consumers become more dependent on their internet-connected smartphones for health information, urgent care centers must adapt their marketing content to mobile devices and include greater use of voice-enabled search and GPS-enabled marketing tactics. When personalized technology started to become widespread in the late 90s and early 2000s, it changed the way companies did business. They were forced to adapt to new marketing tactics and develop creative ways to fend off competitors. Customers …

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