Q. We currently provide DME to our patients as a courtesy to them and then bill their insurance. We generally get paid by most private insurances, but not by Medicare. Our billing department claims Medicare will never pay for any DME we provide because we are not a DME provider licensed with Medicare. If our billing department is correct, would it be compliant to give DME prescriptions to all patients 65 and over? A. I …
Read MoreScribes in the Urgent Care
DAVID WEIN, MD, MBA, FACEP, and DENNIS DIXON, MD For years I was subjected to corporal punishment at the hands of nuns who used to beat me when they could not read my handwriting – at least that is how I remember it. For reasons unknown, my handwriting was never legible. Even back in the day, using the T-System’s “slash and check” charting, my medical records looked like I had either DTs or Benign Essential …
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HIPAA for Urgent Care Centers: A Primer
Urgent message: This article discusses potential penalties for violations of HIPAA and key steps urgent care centers should take in order to avoid such penalties. BART WALKER and MEGGAN BUSHEE Complying with the Health Insurance Portability and Accountability Act (HIPAA) can be a daunting challenge for smaller providers. As the urgent care industry grows, its providers will become much more visible targets for scrutiny by the federal government with respect to HIPAA compliance. In addition, …
Read MoreWhat Percentage of Patients Do Urgent Care Centers Send Elsewhere for Diagnostic Tests?
These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care).
Read MoreMDM, E/M Code with Injection Codes
Q. I was approached by a member of the hospital billing department who does urgent care (office based practice) and emergency department billing about a coding question. As the medical director, they asked for my thoughts and support. It’s nice to work at a place that includes the docs! The question revolves around prescription drug management within the management options under the medical decision making (MDM) section pertaining to E/M calculation. We currently do not …
Read MoreMedical Malpractice Insurance: Read the Fine Print
JOHN SHUFELDT, MD, JD, MBA, FACEP Our emergency medicine group was informed that a new corporate mandate will force us to nearly double our malpractice coverage from $1 million for each occurrence and $3 million in yearly aggregate ($1M/$3M) to $2M/$4M. This mandate came despite our group’s low malpractice claims history, a higher burden of proof for plaintiffs in the state where we practice, and a very “doctor-friendly” malpractice environment in our county. To my …
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Marketing Strategies: School, Sports, and Camp Physicals
Urgent message: Sports physicals offered by an urgent care center can be a “win” for both the center and the community. The community gets a flexible source for a time-critical service and the center gets another way to attract new and repeat business. ALAN A. AYERS, MBA, MAcc Practice Velocity Schools, camps, inter-league and club sports programs typically require a pre-participation physical examination to evaluate a participant’s general health, fitness level, risk of injury and …
Read MoreWhat Percentage of Patients Do Urgent Care Centers Assist in Finding a Primary Care Physician?
These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care).
Read MoreUrgent care codes, E/M Guidelines, ICD-10
Q. Is there a defined set of diagnosis codes for urgent care services and is there a diagnosis code that indicates the services were urgent? A. All facilities use the same set of ICD-9 codes to report the patient’s diagnosis. There are no diagnosis codes to represent urgent care services, but there are certain procedure codes you can use to indicate that services were rendered in an urgent care clinic and also procedure codes to …
Read MoreMalpractice Trends in Urgent Care and Retail Medicine
JOHN SHUFELDT, MD, JD, MBA, FACEP with ANDREW SNIEGOWSKI, RN, JD CANDIDATE 2014 Over the last 6 years I have written a number of articles on medical malpractice in urgent care medicine. The good news is that I am seeing fewer cases despite the fact that there are more urgent care centers and more patient visits. The bad news is that I am still seeing the same fact patterns time and again. Failure to diagnose …
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