<strong>Tips for Payer Reviews</strong>

Tips for Payer Reviews

Monte Sandler Insurance plans are scrutinizing claims more than ever before. Common questions from our clients are: What does this mean? What should I do? Should I be worried? Generally, there are three types of payer reviews: prepayment, postpayment, and probe. The first step is to figure out what type of review it is. What you do and how you handle the review is dependent on that information. Should you be concerned? Always. Payer reviews …

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Retrospective Study on the Impact of Increased Value-Add Time on Patient Experience in Pediatric Urgent Care Centers

Retrospective Study on the Impact of Increased Value-Add Time on Patient Experience in Pediatric Urgent Care Centers

Urgent message: Increase in the proportion of value-add time during an encounter was associated with an increased rate of positive perceptions of timeliness and overall patient experience in pediatric urgent care centers. Aimy Patel, MD; Brian R. Lee, MPH, PhD; Amanda Montalbano, MD, MPH; and Amanda Nedved, MD  Citation: Patel A, Lee BR, Montalbano A, Nedved A. Retrospective study on the impact of increased value-add time on patient experience in pediatric urgent care centers. J …

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A Cause of Dizziness Not to Be Missed

A Cause of Dizziness Not to Be Missed

Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …

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The ‘Triage’ Misnomer in Urgent Care

The ‘Triage’ Misnomer in Urgent Care

Urgent message: While the term “triage” refers to one distinct step in emergency department throughput, in urgent care the concept encompasses a series of activities that span queuing, registering, intake, and the physical exam. Given the clinical and legal implications of the term, including who legally can triage, the term should be avoided in most urgent care settings. Alan A. Ayers, MBA, MAcc According to modern dictionaries, triage refers to the “assignment of degrees of …

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It’s About Time: Repeat Vitals and Long Waits

It’s About Time: Repeat Vitals and Long Waits

Guy Melrose, MB, ChB It was with great interest that I read Dr. Joshua Russell’s opinions on the value of repeating vital signs in the urgent care setting in the November 2022 issue of JUCM.1 Having stated that this does not seem to be common practice amongst his peers, he went on to highlight a couple of very reasonable scenarios in which he recommended repeating vital recordings. Importantly, he alluded to the often-underappreciated phenomenon of …

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A Comparison of Chief Complaints, Specific Diagnoses, and Demographics of Pediatric Urgent Care Visits Before and During the COVID- 19 Pandemic: A Retrospective Study

A Comparison of Chief Complaints, Specific Diagnoses, and Demographics of Pediatric Urgent Care Visits Before and During the COVID- 19 Pandemic: A Retrospective Study

Zaharoula A. Viennas, MD; Julie Martin, MAEd, MMS, PA-C; Benjamin Klick, MD; Tammy Speerhas, DNP, FNP-C, RN, CEN, CME; Turaj Vazifedan, DHSc; Danielle Millspaugh, DNP, FNP-C; Jennifer Ferris, MD; Margret Bedle, MD; Lauren Paluch, DMSc, PA-C; and Theresa Guins, MD Urgent message: Research has shown distinct differences in patterns of children presenting to emergency rooms during COVID-related lockdowns. However, data specific to urgent care have been lacking previously. Citation: Viennas ZA, Martin J, Klick B, …

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A 52-Year-Old Male with Shortness of Breath and a History of Multiple Cardiologic Issues

A 52-Year-Old Male with Shortness of Breath and a History of Multiple Cardiologic Issues

A 52-year-old male with a history of hypertension, hyperlipidemia, and recent myocardial infarction (1 month ago) presents to urgent care with shortness of breath for the past week. He denies fever, chest pain, or cough. On examination, the patient is breathing comfortably and saturating well on ambient air. Review the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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COVID-19 Has Had a Strong Impact on Pediatric Presentations—Well Beyond the Virus Itself

COVID-19 Has Had a Strong Impact on Pediatric Presentations—Well Beyond the Virus Itself

The effects of SARS-CoV-2 itself on various populations in the United States and internationally have been well-documented. Likewise, an ever-growing number of studies have measured the effects of the pandemic on healthcare, the workforce, children’s education…and on and on.               One fact that has been largely overlooked: While social distancing and mask mandates helped reduce spread of COVID-19, with the unintended benefit of reducing the number of cases of other infectious diseases, they did nothing …

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A 7-Year-Old Boy with New Facial Rash

A 7-Year-Old Boy with New Facial Rash

A woman brings her 7-year-old son to the urgent care center with a rash that had developed “over the past few weeks.” On examination, there are smooth, pink papules around the mouth. The mother reports that the patient has a history of asthma, for which he uses inhalation budesonide daily as maintenance therapy. Otherwise he is healthy, has no systemic symptoms, and is well-appearing. View the photo taken and consider what your diagnosis and next …

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