Urgent message: Consider the possibility of appendicitis in the elderly even in the absence of typical/classic symptoms. Acute appendicitis in this population is associated with high morbidity and mortality rates. Author: Alona Dalusung-Angosta, PhD, APN, NP-C and Bryan Holmes, NREMTP Introduction Acute appendicitis is one of the most common causes of abdominal pain, affecting 7% of the general population. The majority of cases occur in patients ages 10 to 30, and the risk of mortality …
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Understanding Your Cost Per Patient
Urgent message: Assessing the true cost per patient is key to determining which pricing model will generate the most revenue for an urgent care center. JORDAN TODD RICE, MD A cost-per-patient analysis may not work for every urgent care center owner, but this article is intended to give JUCM readers the basic tools they need to understand the formulas. It can also serve as a baseline for discussions with urgent care center staff, executives, managers, …
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High-Risk Conditions Presenting as Back Pain (Part 2)
Urgent message: Significant cervical spine injuries are rare in urgent care but missing one can have serious implications for patient and provider. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP In this continuing series on back pain diagnostics in urgent care medicine, we urge providers to carefully consider any high-risk spinal conditions that could be presenting as simple back pain. Although many cases of back pain can be attributed to musculoligamentous injury …
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Enhancing Profits with Travel Health Care
Urgent message: Adding travel health services to an urgent care center can increase a practice’s income and enhance its client base. LYNNE BUNNELL, RN Providing pre-travel health services in an urgent care clinic makes good business sense. The setting is natural to patients who want to be seen for care just days before leaving on a trip. It also works well for those who are more flexible in scheduling visits because their trips are planned …
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Telemedicine’s Impact on Urgent Care: What You Need to Know
Urgent message: Telemedicine represents a new growth opportunity for urgent care centers that want to attract consumers looking for on-demand medicine. IAN VASQUEZ, MBA Urgent care providers are well positioned to take advantage of new market opportunities being driven by consumers and employers who increasingly look to the Internet for on-demand medicine. Telemedicine represents one such opportunity. This article will help you understand applications of telemedicine to urgent care and assess key risks and benefits …
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Urinary Tract Infection in the Pediatric Patient
Urgent message: Diagnosing UTI in a child is challenging in the urgent care setting. Fever, abdominal or back pain, frequency or new onset of incontinence all should raise your index of suspicion. KIMBERLY GIBSON, MD Cases such as the following are common in urgent care and they present unique challenges: J.S., a 2-year-old girl, presents to an urgent care clinic on a Saturday afternoon for evaluation of low-grade fever and fussiness. Her parents have been …
Read MoreReinventing RUC
Lee A. Resnick, MD, FAAFP In my last column, I explained how physician reimbursement is determined by a relatively obscure and highly politicized committee shockingly biased by a specialist representation. The so called “RUC” (Relative Value Scale Update Committee) has created a pay formula that heavily favors proceduralists at the undeniable expense of the primary care physician. This biased system of reimbursement has not only created an unbalanced pay scale amongst physicians, but has equally …
Read MoreApril 2012
Developing Data: April, 2012
These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care centers” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. In this …
Read MoreMedicare Modifier PD, Fracture Visit Coding, Coding for Emergent Transport, ‘Big Ticket’ Reimbursement Codes, Medicare CLIA-Waived Codes
DAVID STERN, MD (Practice Velocity) Q. What is the new modifier PD? A. If your urgent care center is owned by a hospital or health system, then Medicare has a new modifier for your center. The new HCPCS Level II Modifier PD is defined as a “diagnostic or related non-diagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within 3 days, or …
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