Journal of Urgent Care Medicine

Should an Urgent Care Operator Check the National Sex Offender Registry When Hiring Employees?

Urgent message: Failure to identify risks in a new hire’s background can result in “negligent hiring” liability for an urgent care operator, but there are also limitations in what information a center can seek on an applicant. The approximately 7,100 urgent care centers in the United States employ physicians, NPs, PAs, RNs, medical assistants, technicians, and receptionists who provide walk-in patients with medical care for minor health conditions without an appointment. Most urgent care centers …

Who’s the Boss? The Organizational Impact of Bypassing the Chain of Command

Urgent message: A chain of command exists in most organizations to assure efficient and accurate communication, orderly and organized business operations, and proper allocation of time and resources. When the chain of command is broken, however, the entire business can suffer. In American business culture, organizations are typically built in a hierarchal structure and follow an established chain of command. To ensure smooth and efficient operations, employees are generally expected to communicate work issues to …

Maximizing Reimbursement for Services on Campus, off Campus, or on the Phone

Q: We are coding for an urgent care group that is owned by a hospital and bills on a CMS-1500 for professional services and the UB-04 for facility services. We bill using Place of Service (POS) code 22. Is this correct? A: Prior to January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) POS code set did not differentiate between an urgent care operating on campus or off campus. As of January 1, …

Splint and Cast Application Performed by Someone Other than Physician

Q: Can you bill for splint and cast applications done by someone on staff other than the physician? A: Yes, you can still bill for the service if the application is performed by someone else in the clinic. The American Medical Association (AMA) provided guidance on this in the Current Procedural Terminology (CPT) Assistant, April 2002 issue: “You will note that the reference to ‘physician’ has been retained in the clinical examples provided. This inclusion …

Enhancing Urgent Care Profits with Travel Medicine

Urgent message: Travel medicine is a service addition that enables urgent care operators to attract more patients and increase revenue from existing patients while leveraging existing infrastructure and personnel. When an urgent care center’s patient revenues exceed operating expenses, the operation is said to have achieved break-even profitability—at which point each incremental patient visit contributes directly to the bottom line. Nevertheless, in the face of rising fixed costs and falling payer reimbursements, many centers still …

Complying with the Stark Law Across Multiple Center Locations

Urgent message: The “in office ancillary services exception” to the Stark law enables urgent care centers to offer a range of services in-house, but complications arise when the urgent care operation consists of multiple locations. Urgent care centers are almost certainly familiar with the Stark law, a federal conflict-of-interest statute designed to help curb physician self-referral. It is a particularly exacting regulation, but there are numerous exceptions that may help healthcare providers avoid liability—the common …

SEASONALITY OF SEXUALLY TRANSMITTED INFECTIONS VS NORMAL URGENT CARE SEASONALITY

A Practice Velocity study of 63,000 patient charts presenting with one of 35 diagnoses associated with sexually transmitted infections (STI) between January 2010 and November 2016 reveals the highest incidence occurs during the late summer/early autumn. With urgent care’s typical seasonality driven by upper respiratory illness, which is most prevalent in the winter months, STI presentations actually run contra-seasonal to “typical” urgent care volume.

Navigating Around Legislative Obstacles and Proving Value in 2017

Urgent care in a shifting healthcare delivery environment brings to mind Shel Silverstein’s children’s classic, The Missing Piece Meets the Big O. In that tale, the missing piece stands alone, waiting for someone to come along and take it somewhere. Various shapes come by, but none are quite right. Some could not roll. Some had too many missing pieces. Finally, a shape comes along that fits just right and they roll along until the missing …

Cost-Effective Staffing with Medical Assistants

Urgent message: Medical assistants (MAs) provide flexible, cost-effective clinical support for urgent care centers. With proper training and working under a physician’s supervision, an MA can perform most basic support functions in this setting. Introduction While there’s a lack of verifiable data as to the total number of unsuccessful urgent care endeavors, we can presume at least one common reason urgent care centers shutter their doors and permanently cease operations: they exhaust their working capital. …

100 Largest Urgent Care Center Operators

The 100 largest urgent care operators in the United States run approximately 25% of the locations under their banners, according to research by Practice Velocity and National Urgent Care Realty. They’re getting even bigger, too; the number of locations owned by the companies on the list expanded by about 20% this year. While ownership was once delineated between hospital-affiliated and independents, several multi-unit operators now operate in some (but not all) of their markets as …