Practice Management
Q: What is case-rate reimbursement, and how does it work in the urgent care sector? A: Case rate, sometimes called flat rate, describes a reimbursement structure in which providers receive a flat reimbursement rate for every patient visit, no matter what service they provide. Case-rate reimbursement means that the urgent care is contracted with the payor to receive the same reimbursement regardless of the acuity of care, whether it’s the treatment of a hangnail or …
Read MoreUrgent message: While many people perceive HIPAA as a law governing patient privacy, protection and standards for personal health information is only one aspect of this law, which was originally intended to regulate health insurance. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine. Introduction Ask anyone—even the owner of an urgent care center—what HIPAA is, …
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Urgent message: U.S. healthcare has been a monolith of inefficiency, limited access, and untenable costs for decades, due mainly to a lack of healthy competition. Today’s healthcare landscape, however, spurred by converging market forces, is rapidly evolving into a competitive marketplace, with urgent care being one of the key catalysts for this welcomed and long overdue change. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice …
Read MoreUrgent care insiders know our industry continues to grow and evolve, and understand that convenience, cost, and quality of care are what keeps patients coming back. Data from outside the industry diving a bit deeper into the “why” of patient volume has been a bit scarce, however. A Harris Poll commissioned by Mercy Health System of Southeastern Pennsylvania takes a step toward remedying that shortage, however. Not surprisingly, a strong majority (66%) of the 1,700 …
Read MoreQ: Do you have information on the 2017-2018 influenza vaccine codes? A: The American Medical Association (AMA) recently published a list of new and revised vaccine codes on their website (https://www.ama-assn.org/sites/default/files/media-browser/public/cpt/vaccine-long-desc-july-2017.pdf). These codes will be published in the 2018 Current Procedural Terminology (CPT) manual. The two new influenza vaccines on the list are: 90682, “Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use” 90756, …
Read MoreUrgent message: Urgent care centers must use all reasonable efforts to comply with informed-consent and consent-to-minors laws. This should include consulting with legal counsel on the specific laws of the state and developing protocols to shield the center from possible litigation. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine. Introduction Medical practices like urgent care centers …
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Urgent message: Urgent care centers exist to help people who need to see a healthcare professional today. When that need coincides with a natural or manmade disaster, every location must have a plan of action to ensure any downtime is minimal, staff needs are met, and the business is able to survive. Introduction No region of the country—for that matter, no state, town, neighborhood, or block—is immune from disabling disasters. Hurricanes, tornadoes, flooding, forest fires, …
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Urgent care operators who offer occupational medicine services should be aware that new guidelines for federal workplaces include mandatory screening for four relatively common opioid pain medications. As of October 1, employee drug tests must include screens for oxycodone, oxymorphone, hydrocodone, and hydromorphone. The Substance Abuse and Mental Health Services Administration (SAMHSA) says this will mainly affect some 400,000 federal employees with public health, public safety, and national security responsibilities. Positive results that are not …
Read MoreIn this issue of JUCM, we inaugurate a new focus on treating children in the urgent care center. This will manifest in the form of semiregular articles by clinicians who’ve made the commitment to focus on pediatric urgent care. The first, Approach to the Child with Chest Pain, appears on page XX. We are not alone in recognizing that urgent care is ideally suited to the treatment of children whose presenting symptoms don’t warrant a …
Read MoreQ: What can we bill for when we give a patient a nebulizer treatment for an acute airway obstruction during an exacerbation of asthma, or wheezing due to an upper respiratory ailment? A: You can bill for the service and the medication. However, depending on the payer rules, the medication might be bundled into the service. Time is a factor when billing the service. If the treatment is less than 1 hour, you would bill …
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