Q: 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 …
Read MoreUnderstanding the Ins and Outs of Triple Net Leases
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. Urgent Message: As urgent care expands into traditional retail space, it’s important to understand the obligations of leases that require tenants to act as property “owners” responsible for all taxes, utilities, and maintenance of the real estate. While the defining characteristic of urgent care facilities across the country …
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Why Urgent Care Needs More Controllers, Fewer Empathizers
Urgent message: The rise of self-service technologies means that when patients actually do need to interact with frontline staff to resolve a service issue, their more complicated issues, more stringent demands, and higher expectations require an opinionated and outspoken “controller” personality type to take control of the situation. As urgent care relies on positive of word-of-mouth to drive new and repeat visits, a center not only must deliver an exceptional patient experience, but also resolve …
Read MoreCome October, Come the Flu
On paper, flu season starts next month, meaning it’s an ideal time to start reminding patients they’ll need flu shots (and that you’ll be happy to provide one). While the majority of children tend to get their shots toward the end of the season according to the Centers for Disease Control and Prevention, the distribution has been more evenly distributed for adults over the past few flu seasons, as seen in Figure 1, below. The …
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2018 ICD-10-CM: A Preview of Urgent Care-Relevant Changes
It’s again time to review what has changed with the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) effective October 1, 2017 through September 30, 2018. There are 360 new, 142 deleted, and 226 revised diagnosis codes in the final update. We will review the changes most relevant to urgent care, but the examples shown here are not all-inclusive. You can find all updates in the Centers for Medicare and Medicaid Services (CMS) website …
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Walk-In Primary Care: What Does It Mean for Urgent Care?
Urgent message: As many primary care providers expand their hours and offer walk-in service, the lines between urgent care and primary care become blurred. To remain competitive, urgent care operators will need to more clearly define their value to patient and payers, increase the acuity of services offered to reduce duplication, and become more innovative in their service delivery and partnerships. ALAN A. AYERS, MBA, MAcc Introduction For years, many primary care physicians (PCPs) have …
Read MoreStreamlining Management of Shared Employees Across Multiple Locations
Urgent message: Ongoing growth within the urgent care industry intensifies competition for competent professionals. “Sharing” trusted workers across multiple sites can help keep costs in check and ensure efficient practices—provided it’s done right. Andraya Carson-Hruby and Vance Daniels It is a good time to be in the urgent care business: According to the Urgent Care Association of America’s 2016 Benchmarking Report, there was a 10% increase in the number of urgent care centers across the …
Read MoreWhen 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 …
Read MoreUrgent 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 …
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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 …
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