Practice Management
Urgent message: As urgent care remains a hotbed of merger, acquisition, and transactional activity, owners and operators may see a prime opportunity to sell their practices at maximum market value. The complexities of selling (or buying) an urgent care practice can make it a daunting undertaking, however, and thus requires careful planning, expert counsel, and due diligence to pull off successfully. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and …
Read MoreAlan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: Physician assistants and nurse practitioners perform many of the same tasks as physicians in urgent care settings, but ambiguity as to the nature of their practice means additional consideration must be given in how their pay is structured. The federal Fair Labor Standards Act1 (FLSA) states that all …
Read MoreThe Centers for Medicare and Medicaid Services announce an update to claim adjudication rules for National Correct Coding Initiative Procedure-to-Procedure edits to allow bypass of an edit if modifiers 59, XE, XS, XP, or SU are appended to either the column one or column two code. In 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the following modifiers, referred to as X{EPSU} and intended to provide more information in scenarios where modifier -59, …
Read MoreUrgent care started as something akin to the California Gold Rush; if a physician had the resources, the inclination, and the chutzpah to do so, they could stake a claim in the great wilderness of this new way of practicing medicine. The more reticent (some would have said prudent at the time) stayed in their lanes to continue practicing traditional family medicine, or pediatrics, or take shifts in the emergency room. Competition was scarce. That …
Read MoreQ: During a recent internal audit of claims where x-rays were being billed, it was brought to my attention that we were not using the appropriate modifiers since we use computed radiography (CR) x-ray machines. What are those modifiers and will using them affect my reimbursement? A: As outlined in the Consolidated Appropriation Act of 2016, the Centers for Medicare and Medicaid Services (CMS) imposed reimbursement cuts to the technical component for x-rays performed on …
Read MoreUrgent message: The increasingly visibility of “whistleblower cases,” in which employees share in any fines from reporting their employer’s malfeasance to federal and state authorities, calls for urgent care center owners to understand the False Claims Act and the whistleblower lawsuit process. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. A “whistleblower” is an employee who makes complaints …
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Urgent message: Changes to insurance plan design are resulting in increased financial exposure for patients, with urgent care providers scrambling to adapt to the associated rise in patient consumerism. It therefore behooves the urgent care provider to evolve their financial systems and policies such that they align with emerging point-of-sale best practices in order to meet patient expectations, enhance the revenue cycle, and cultivate patient loyalty. Alan A. Ayers, MBA, MAcc is Chief Executive Officer …
Read MoreThis month’s Practice Management feature article, Perfecting the Consumer Financial Experience in Your Urgent Care Center, reveals that with increasing flexibility in accessing healthcare, patients also want more flexibility when it comes to paying their bill. Their insurance status comes into play, as do methods of payment. It’s been suggested that such details may even play a part in choosing where they go when they need to see a provider. As such, it could be …
Read MoreUrgent message: While competition for patients among urgent care operators can be intense, speaking negatively of a competitor online can lead to unwanted liability. Alan A. Ayers, MBA, MAcc Competition between businesses can be intense. In some instances, comparisons between one company and another can lead to disparaging and inaccurate claims. This can result in unneeded liability for an urgent care owner. Here, we examine how the law of defamation in social media applies to …
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Urgent message: The idea of a “typical” urgent care operation buyer is evolving along with the industry. While private equity has been an essential player in market growth, healthcare organizations with longer-term vision are now more commonly involved in acquisitions. Corey Palasota, CFA and Emily Schmidt, CFA It’s no secret private equity (PE) has a played a paramount role in the design, development, and growth of the urgent care industry. Collectively, these firms have invested …
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