Journal of Urgent Care Medicine

Recognizing Employee Disengagement and Taking Steps to Re-engage

Urgent message: Employee disengagement is pandemic in the American workplace. At urgent care centers, operators have to work especially hard to keep frontline staff members motivated. Re-engaging employees starts with a strong management culture committed to establishing affinity with employees and ensuring that systems and processes support day-to-day operations. ALAN A. AYERS, MBA, MAcc, Experity For many urgent care operators—clinically adept physician–owners who are likely green as entrepreneurs—it can be sobering to realize just how …

Medical Malpractice Trial, Part 2: Pretrial

JOHN SHUFELDT, MD, JD, MBA, FACEP Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: Johnny Trey Dalton Attorney …

Modifier -X {EPSU}, Pneumococcal Immunizations

Q. Have there been any updates from CMS (Centers for Medicare & Medicaid Services) regarding the new -X modifiers that were introduced in January of this year? A. CMS released MLN Special Edition article SE1503 on January 22, 2015 (see http://www.cms.gov/Outreachand- Education/Medicare-Learning-Network-MLN/MLN MattersArticles/Downloads/SE1503.pdf), stating that there would be forthcoming guidance as to the appropriate use of the new -X {EPSU} modifiers and “that guidance will include additional descriptive information about the new modifiers” before implementing …

Medical Malpractice Trial, Part 1: The Events

John Shufeldt, MD, JD, MBA, FACEP I recently spent 3 amazing weeks in a medical malpractice trial. Over the next few months, I would like to share the experience with you. Despite the fact that I practice law and have been an expert witness for more than 20 years, the experience opened my eyes and has definitely changed how I practice medicine in the urgent care setting. I took copious notes during the trial and …

Image Check: Impact of Employee Appearance on the Patient Experience

Urgent message: Patients often infer quality on the basis of outward appearances. Adopting a policy that addresses clothing, grooming, and body art can help balance the need to project a professional image in the urgent care center and to ensure workplace safety with employees’ desire to express themselves. ALAN A. AYERS, MBA, MAcc Practice Velocity Remember the popular 1990s advertising slogan “Image is everything”? What was back then a trendy catchphrase created to peddle expensive …

Fracture Codes, Strapping and Splint Application Codes, S9088

Q. I was told that we can no longer use code 80100 for drug screens. We have several employers who send employees and potential employees to our urgent care center for pre-employment, random, and post-accident drug screens. What code should we use now? A. Effective January 1, 2015, several drug-screen Current Procedural Terminology (CPT) codes were deleted by the American Medical Association: 80100: “Drug screen, qualitative; multiple drug classes chromatographic method, each procedure” 80101: “. …

Developing Data: March, 2015

Data from the IBISWorld Industry Report Urgent Care Centers in the US, March 2014 show that the urgent care market can be segmented by the source of payment for services. On the basis of data from the U.S. Census Bureau, IBISWorld finds that the main sources of revenue for urgent care are private insurance, Medicare, patients (out-of-pocket payments), and Medicaid. Private insurance accounted for about 54.8% of industry revenue in 2014. Many private insurance companies …

Medical Boards: Part 2

JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP The probability that you will receive a certified letter from your medical board informing you about an investigation is relatively low. But one day, you may be one of the unlucky souls who receives such a letter. What do you do? Different boards have different rules about what gets reviewed or investigated and what does not. Some boards are mandated to investigate, at least to …

Developing Data: February, 2015

Payor Contracts, Discounts, and Provider Signatures

Q. We sometimes have patients come in to our urgent care center with an insurance payor that we do not have a contract with. We do not want to turn them away, but we do want to guarantee our payment. Do we have to submit a claim to the insurance company in such cases? Currently, we offer these patients a self-pay discount, and they pay us in full at the time of service. A. Typically, …

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