Practice Management

Posted On March 16, 2017 By In Developing Data

How Patients Pay Their Bills

Of the survey participants, most (78%) manage billing with in-house staff, while the rest contract for their billing services or use other methods. Such billing efforts cost an average amount of $215.91 per patient—about $3,336,967 per site and $8,876,333 per urgent care center. Small wonder, then, that 14% of respondents cannot yet call their business “profitable.”Read More
Over two-thirds of urgent care centers offer a blend of occupational medicine services (generally defined as treatment of workers compensation injuries, conducting physicals for compliance or fitness for duty, and substance abuse testing), according to the Urgent Care Association of America.1 One challenge for those that do is that the overall incidence of workplace injuries has declined significantly this century, due to an overall shift from a manufacturing to a service and information economy, the offshoring/outsourcing of U.S. manufacturing jobs, and employer investments in safety, prevention, and automation. Simply put,Read More
Urgent message: Failure to identify risks in a new hire’s background can result in “negligent hiring” liability for an urgent care operator, but there are also limitations in what information a center can seek on an applicant. The approximately 7,100 urgent care centers in the United States employ physicians, NPs, PAs, RNs, medical assistants, technicians, and receptionists who provide walk-in patients with medical care for minor health conditions without an appointment. Most urgent care centers around the country are owned by physician‒entrepreneurs. While many larger corporate and hospital-affiliated urgent careRead More
Urgent message: A chain of command exists in most organizations to assure efficient and accurate communication, orderly and organized business operations, and proper allocation of time and resources. When the chain of command is broken, however, the entire business can suffer.  In American business culture, organizations are typically built in a hierarchal structure and follow an established chain of command. To ensure smooth and efficient operations, employees are generally expected to communicate work issues to the supervisor directly above them in the hierarchy for direction and resolution. Conversely, high-level managers,Read More
Q: We are coding for an urgent care group that is owned by a hospital and bills on a CMS-1500 for professional services and the UB-04 for facility services. We bill using Place of Service (POS) code 22. Is this correct? A: Prior to January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) POS code set did not differentiate between an urgent care operating on campus or off campus. As of January 1, 2016, the criteria for outpatient hospital services have changed. If the hospital elects to billRead More
Q: Can you bill for splint and cast applications done by someone on staff other than the physician? A: Yes, you can still bill for the service if the application is performed by someone else in the clinic. The American Medical Association (AMA) provided guidance on this in the Current Procedural Terminology (CPT) Assistant, April 2002 issue: “You will note that the reference to ‘physician’ has been retained in the clinical examples provided. This inclusion does not infer that the cast/splint/strap procedure was performed solely by the physician, as nursesRead More
Urgent message: Travel medicine is a service addition that enables urgent care operators to attract more patients and increase revenue from existing patients while leveraging existing infrastructure and personnel. When an urgent care center’s patient revenues exceed operating expenses, the operation is said to have achieved break-even profitability—at which point each incremental patient visit contributes directly to the bottom line. Nevertheless, in the face of rising fixed costs and falling payer reimbursements, many centers still struggle to grow profits year after year. Thus, urgent care operators often look to ancillaryRead More
Urgent message: The “in office ancillary services exception” to the Stark law enables urgent care centers to offer a range of services in-house, but complications arise when the urgent care operation consists of multiple locations. Urgent care centers are almost certainly familiar with the Stark law, a federal conflict-of-interest statute designed to help curb physician self-referral. It is a particularly exacting regulation, but there are numerous exceptions that may help healthcare providers avoid liability—the common federal exception Stark In-Office Ancillary Services Exception (IOASE) being one. This exception is designed toRead More