Q. We sometimes have patients come in to our urgent care center with an insurance payor that we do not have a contract with. We do not want to turn them away, but we do want to guarantee our payment. Do we have to submit a claim to the insurance company in such cases? Currently, we offer these patients a self-pay discount, and they pay us in full at the time of service. A. Typically, …
Read More
February 2015
A Process Approach to Differentiating Your Urgent Care Brand by Ensuring That Patients Leave Satisfied
Urgent message: Rapid growth of the urgent care industry has led to increased competition but little differentiation among urgent care providers, which consumers tend to view as “pretty much the same.” The opportunity for urgent care is thus to foster patient loyalty by creating differentiated brands, which starts by taking a process approach to the patient experience. ALAN A. AYERS, MBA, MAcc Urgent care is maturing into a big business. In 2015, the industry’s nearly …
Read More
Baby Born with Pustules on the Neck
A new mother is concerned because her baby boy was born with scattered pustules on his neck. The baby is full term and was born to a mother who had adequate prenatal care and no evidence of sexually transmitted infections. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge 2: January, 2015
Case A 68-year-old man with a long history of uncontrolled hypertension and hyperlipidemia presented with unilateral decreased vision for the last 3 weeks. On exam, you saw a fundus with diffuse retinal hemorrhages and swelling.
Read More
Child with Lymphedema of the Neck and Parotid Glands
This image was taken of a 3-year-old boy who presented with history of 3 days of fever and headache and 1 day of diffuse lymphedema of his neck and parotid glands. The area surrounding each parotid gland was tender to palpation. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: January, 2015
Case An 80-year-old man woke up with a localized area of erythema on his forehead. He didn’t think much of it, until the lesion slowly became white and then started turning blue over a few hours. He says that the lesion is painful and is getting larger and darker. He denies the presence of headaches, muscle pain, abdominal pain, sweating, and tremors.
Read More
January 2015
Developing Data: January, 2015
Data from the Bureau of Health Professionals show that lack of access to primary care in the United States is driving the heightened demand for urgent care utilization. As of 2013, approximately 60 million individuals in the United States lacked access to primary care, an increase from 56 million in 2007. The lack of access is driven by a number of factors, including inconvenient hours, stringent scheduling requirements, and overcapacity at primary care physician offices. …
Read MoreFracture Codes, Strapping and Splint Application Codes, S9088 Code
Q. When is it appropriate to use fracture codes without manipulation? If a patient comes in with pain in a finger after a fall and an evaluation and management is performed, x-rays are taken to confirm a fracture, the finger is splinted, and the patient is referred to an orthopedist, would that treatment constitute billing for fracture care? If not, what must we do to be able to bill these? A. CPT suggests that only …
Read More