JOHN SHUFELDT, MD, JD, MBA, FACEP lease don’t share this with anyone but truth be told, I love paramedics. I sometimes thought I had it bad (I really didn’t think that, but it makes the story better if I sound tragic) treating the myriad disenfranchised in an inner city ED until I talked with the paramedic who wrestled the feces-covered, bath salts and meth-using, naked, combative maniac who was my patient the previous night. (The …
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Improving Urgent Care Center Profitability Through Medical Supply Management and Accounting
Urgent message: Many urgent care centers lack an inventory management process and do not accurately account for their utilization of supplies. Improving how a center manages and accounts for supplies can have a direct impact on the bottom line. ALAN A. AYERS, MBA, MAcc Practice Velocity Introduction A quick and easy way to improve your urgent care center’s profitability may be as close as your supply closet. Many urgent care centers lack defined processes for …
Read MoreDeveloping Data: November, 2013
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). In …
Read MoreCoding Intravenous Infusions with Hydration; Medical Decision Making
DAVID STERN, MD (Practice Velocity) Q. We perform a lot of IV infusions in our urgent care facility. Sometimes we also perform IV pushes and hydration at the same time as the infusion. We have been billing CPT codes 36000, 96365 -59, 96360 -59, and 96374 -59. Medicare pays for these codes when we append the -59 modifier but I am concerned that this may not be the correct way to bill after reviewing some …
Read MoreUsing Physician Extenders
JOHN SHUFELDT, MD, JD, MBA, FACEP You breathe a deep sigh of relief after learning that you were not the treating provider of a patient who came into your urgent care center and had an unexpected bad outcome. The patient was seen by your mid-level provider who works on opposite days from you in your center. As documented in the medical record, the patient sounds benign: a 28-year-old female who presented with continued sinus symptoms …
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Post-Visit Follow-up Calls: Improving Patient Satisfaction, Center Profitability and Clinical Outcomes
Urgent message: Call-backs within 24 to 48 hours of discharge can identify potential complications, ensure that instructions are followed, and reinforce a positive visit experience. ALAN A. AYERS, MBA, MAcc, Experity Introduction Urgent care centers provide immediate medical attention to patients who feel their symptoms are too pressing to wait for an appointment with their primary care physician, but not serious enough to warrant a visit to the emergency room (ER). With extended night/weekend hours, …
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Achieving Consistency and Scalability in Urgent Care Service Delivery
Urgent message: Investing time in designing repeatable processes and documentation can pay off in a more efficient, effective, and scalable urgent care operation. ALAN A. AYERS, MBA, MAcc Practice Velocity Introduction Despite management’s best intentions to deliver extraordinary patient experiences, many times employees just don’t know what to do. Front-line staff members are often conflicted between “doing what’s right” for the business, avoiding management scrutiny, exerting extra unrewarded effort, and “doing what’s right” for the …
Read MoreThe New Normal of Medical Malpractice and How We Are Making it Worse
JOHN SHUFELDT, MD, JD, MBA, FACEP I am tangentially involved in a medical malpractice suit in which the physician in question complied completely with the standard of care. Her documentation was great, her care exceptional, there was no discrepancy between her charting and the nurses’ charting, the doctor-to-doctor hand-off went well, and she communicated with the patient and family. Unfortunately, the ultimate patient outcome was horrible. In the aftermath, the physician was named in a …
Read MoreSupervising Physician, Physician Rotation, Critical Care
DAVID STERN, MD (Practice Velocity) Q. Can a Physician Assistant (PA) bill a claim under a supervising physician even when the supervising physician is not physically present during the patient visit? A.A PA can render services when the physician is not on site. Incident-to billing (a specific CMS method for billing midlevel services with the physician as rendering provider) would never apply in this case. Services rendered in this situation should be billed with the …
Read MoreDeveloping Data: October, 2013
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). In …
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