Practice Management

There’s little evidence that emerging payment models (eg, concierge medicine, cash-only practices, and accountable care organizations [ACOs]) are gaining any serious traction in urgent care—but that doesn’t mean they’re not making headway elsewhere. ACOs, in particular, are growing in usage among physicians, according to the Medscape Physician Compensation Report 2017. Usage of cash-only and concierge models is also growing, albeit much more modestly, as the graph below shows. Data source: Medscape Physician Compensation Report 2017. Available at: http://www.medscape.com/slideshow/compensation-2017-overview-6008547. Accessed April 11, 2017. Data reflect the responses of 19,270 physicians acrossRead More
Q: We are planning to open a new clinic that will offer both primary care and urgent care services. Can we use the same tax identification number (TIN) when we start negotiating contracts with insurance payors? A: Based on our experience with doing this many times, if you attempt to use the same TIN for both primary care (PC) and urgent care (UC), you are likely to see the following results: Some payors are likely to refuse to give both contracts to the same entity. Some will be fine withRead More
 Urgent message: Urgent care centers need engaged and effective operations leadership, which entails clearly defining managerial roles, individual skillsets and personality characteristics and also having a process for attracting, interviewing, and qualifying managerial candidates. Jim Clifton, the highly respected CEO of global performance and research leader Gallup, has often stated that hiring the right manager is by far the most critical decision a company makes. Given how multifaceted and demanding urgent care operations can be at times, this maxim rings especially true in our industry. Putting a competent, skilled urgentRead More
Urgent message: While unemployment insurance claims can cost an urgent care center through higher future premiums, there are multiple considerations for when a center should contest or approve an unemployment claim. Urgent care centers, as service businesses, frequently experience a high rate of turnover among their less skilled, frontline staff—eg, receptionists, clerks, and medical assistants. Whether an employee quits or is terminated for cause or performance, a common issue for urgent care center owners is determining in what circumstances an employee is entitled to unemployment compensation—and when an employer shouldRead More
Introduction It should not be surprising that when hospital executives and personnel sit down to discuss issues and problems around population health, accountable care organization (ACO) integration, network development, cost containment, new product lines, hospital readmission rates, care coordination, and related topics they often arrive at hospital-centric and hospital-based solutions to solve them.1 As hospitals and hospital networks look to urgent care centers to address some of these issues through hospital/urgent care affiliations, joint ventures, hospital-owned urgent cares, and other models, the basic relationship between these partners can have someRead More

Posted On March 27, 2017 By In Health Law

Who Owns Patient Medical Records?

Urgent message: While historically there has been an understanding that patients own the information contained in their medical records, and that providers own the record itself, the current lack of a federal law governing the ownership of medical records poses a conundrum when those records are stored electronically. New challenges demand innovative solutions—often in the form of new technologies that make life easier. Certainly technology has advanced healthcare to improve and lengthen our lives. Yet, perhaps more noticeable in the medical realm than in other fields, we see the clashRead More
Medical assistants (MAs) are the core of urgent care’s clinical support workforce (as noted in Cost Effective Staffing with Medical Assistants in the January, 2017 edition of JUCM; see http://www.jucm.com/cost-effective-staffing-medical-assistants/). However, according to the Bureau of Labor Statistics, demand for MAs is expected to outstrip supply over the next decade, just as the aging baby-boom population will increase demand for physician services—especially in the primary care setting, where the bulk of MAs work. For urgent care operators, a 23% increase in demand for MAs (compared with 7% for all otherRead More

Posted On March 27, 2017 By In Coding Q&A

Coding for Critical Care Services

Q: Can we bill for critical care services when spending extra time with patients who are very ill? A: It is rare that you would perform billable critical care services in the urgent care setting. According to the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA), critical care is defined as the direct delivery by a physician(s) of medical care for a critically ill or critically injured patient. A critical illness or injury acutely impairs one or more vital organ systems such that there isRead More