Journal of Urgent Care Medicine

When Billing by Exam Type, the Revenue Is in the Details

Q: What is the difference between a detailed exam and an expanded problem-focused exam? A: Unfortunately, there is no straightforward answer to that question. The Centers for Medicare and Medicaid Services (CMS) provides some guidance in the 1995 and 1997 guidelines (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/CMS1243514.html). The 1995 guidelines state the documentation of the examination as follows: Problem-Focused – A limited examination of the affected body area or organ system. Expanded Problem-Focused –A limited examination of the affected body …

Urgent Care Operator’s Liability for a Car Crash into the Center

Urgent Message: The owners and operators of urgent care centers are liable only for “foreseeable” events, which generally excludes a car crashing into an urgent care center and other “freak” accidents. Perhaps it’s the last story on a newscast, or in the strange-but-true section of the newspaper or a website: a vehicle crashes into an urgent care center. As strange as this news may seem, it’s not entirely uncommon. In the past decade, there have …

Calculating the Value of a Like: The Muddled ROI of Facebook Advertising

Urgent message: Ideally, paid advertising should show a return on investment based on the revenue it generates. However, revenue-based metrics are difficult to prove using social media, in which “likes” are more valuable in identifying fully engaged patients than generating direct sales. When it comes to social media marketing channels, Facebook remains atop the throne. The fact that 80% of Fortune 500 companies have an active Facebook page more than supports that assertion, and stands …

Opioid Visits Keep Skyrocketing

Driven partially by increased use of the powerful synthetic opioid fentanyl, patients continued to flood emergency rooms across the country in increasing numbers over the 10-year period ending in 2014, according to data from the Agency for Healthcare Research and Quality (AHRQ; see graph below). The implications for urgent care are A) that some of those patients surely received their first opioid prescriptions in an urgent care center legitimately for treatment of acute pain, underscoring …

The Financial and Clinical Case for Bringing Onsite Lab Testing to Your Urgent Care Center Webinar

How often do patients utilize urgent care?

Urgent care thrives on repeat visits and positive word-of-mouth from loyal patients. Although many urgent care centers track the percentage of new vs established patients—those who have been seen in the past 3 years—few measure frequency of use by individual patients. This is an important measure used in other service businesses, however, based on the assumption that customers who patronize their favorite businesses more often also spend more money, and encourage others (either in person and …

Level of Billing Complexity Follows Level of Lacerations in Wound Repair

Q: We had a patient present with multiple lacerations and were wondering how to bill, since some were repaired with sutures and some were repaired with staples. A: Laceration repair is billed based on the complexity, length of the repair, and the anatomic site. The repair can consist of sutures, staples, or wound adhesive (eg, Dermabond). The Current Procedural Terminology (CPT) manual classifies the complexity of the repair of wounds as being simple, intermediate, or …

Quality Improvement Report: Elevated Blood Pressure Referrals in an Urgent Care Setting to Increase Follow-Up Appointments with Primary-Care Providers

Urgent message: Urgent care providers are valued for their ability to treat nonemergent acute healthcare needs efficiently, but in so doing they are also well positioned to identify other, underlying healthcare issues such as hypertension. Introduction Heart disease is the leading cause of death in the United States and accounts for approximately 24% of all deaths.1 Many known risk factors are associated with heart disease, including high blood pressure. The Centers for Disease Control and …

Why Are You Being Sued?

Urgent message: “Winning” a lawsuit in which you’re the defendant runs a distant second to avoiding lawsuits altogether—never mind if you’re on the losing end and have to pay a judgment. Understanding relevant regulations and laws is the best way to stay out of court. Today’s healthcare providers must carefully navigate their way around complex laws and regulations which regulate, restrict, and impact their practices. Urgent care providers who fail to navigate within these laws …

Recognizing and Preventing Provider Burnout in Urgent Care

Urgent Message: Urgent care demands that providers meet goals for fast patient turnaround and positive patient experiences, which when combined with tight staffing makes recognizing and preventing provider burnout a priority for urgent care providers. It’s been said that providers are the lifeblood of any healthcare organization. Indeed, they’re the collective engines that make everything go, such that their focused engagement and dedicated patient care are critical for organizational success. But that dedication often leaves …