Supervising Doctors May be Held Liable in Malpractice Suits

Supervising Doctors May be Held Liable in Malpractice Suits

Urgent Message:  A supervising physician can be named in a lawsuit for malpractice against a nurse practitioner or physician assistant, however, there are steps supervising physicians can take to protect themselves against such actions. Alan A. Ayers, MBA, MAcc In urgent care settings, physicians are often responsible for supervising and overseeing a team of other healthcare employees, including nurse practitioners (NPs), physician assistants (PAs), and medical assistants (MAs). If any member of this team is …

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What is a False Claim?

What is a False Claim?

Benjamin Barlow, MD; Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC The False Claims Act (FCA) is a federal statute enacted in 1863, inspired by defense-contractor fraud during the Civil War. Today it is used to prosecute inappropriate billing in the healthcare setting. Any person who knowingly submits false claims to the government (ie, Medicare, Medicaid, and Tricare) is liable for 3 times the government’s damages plus a penalty that is linked to inflation. Penalties are per …

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Nine Recurring Coding Pitfalls for Urgent Care Clinicians to Avoid

Nine Recurring Coding Pitfalls for Urgent Care Clinicians to Avoid

Brad Laymon, PA, CPC, CEMC Over my career as a physician assistant, I have delved extensively into the intricacies of medical coding guidelines. Through collaborative initiatives with healthcare systems and fellow clinicians, I have been able to identify 9 common, recurring coding pitfalls. This process came with significant time and experience, and I want to share what I’ve learned as my ultimate objective has always been advancing charting accuracy to instill confidence among providers in …

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How Urgent Care is Becoming More Corporatized

How Urgent Care is Becoming More Corporatized

In 2023, the urgent care industry added 1,057 de novo locations—new sites that did not previously exist. But these new centers are far more likely to be owned by larger entities with 10 or more units, also called “enterprise” operators.  In fact, according to data from National Urgent Care Realty analyzed by Experity, for the past 4 years, 10+ unit operators have been the drivers of new rooftop growth. Prior to 2020, the industry was led …

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Why Specialty Recognition Matters More Than Ever for Urgent Care

Why Specialty Recognition Matters More Than Ever for Urgent Care

Commuting in Jakarta can be a nightmare. The average citizen in Indonesia’s capital city spends weeks stuck in urban transit each year. Compare this with Singapore, which is consistently rated one of the best cities in the world for commuters. The difference between the day-to-day experience of residents of each city is stark. The root cause of why these two metropolises of southeast Asia have such disparate commuter experiences lies in the contrast of how …

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Which IV Infusion Services are Most Appropriate for Urgent Care?

Which IV Infusion Services are Most Appropriate for Urgent Care?

Urgent Message: When offered as a medical service consistent with an urgent care center’s branding, IV infusion services can enable new revenue streams and expand the center’s appeal to a new base of patients. Alan A. Ayers, MBA, MAcc According to the Urgent Care Association (UCA), the capability to administer intravenous (IV) medications is a defining feature of urgent care.1 Along with x-ray services and suturing, the availability of IV treatment differentiates urgent care from …

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Updates on Sports Related Concussion from the 6th International Conference on Concussion in Sport

Updates on Sports Related Concussion from the 6th International Conference on Concussion in Sport

Over the last 20 years, the Concussion in Sport Group has met periodically to develop statements guiding the assessment and management of sports related concussions. The most recent meeting of the group took place in Amsterdam, Netherlands, in October 2022 and produced updated and freely available, evidence-informed tools to assist in the detection and assessment of sports related concussion (SRC). These tools include: the Concussion Recognition Tool-6 (CRT6); Sport Concussion Assessment Tool-6 (SCAT6); Child SCAT6; …

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Robust Urgent Care De Novo Growth Continues

Robust Urgent Care De Novo Growth Continues

The urgent care industry continues to add de novo centers, according to data from Experity and National Urgent Care Realty. Although de novo growth slowed in 2023 by 5%, 2023 de novos are still 16% higher than 2019, the last pre-pandemic year. In addition to continued overall growth of the industry, the data indicates structural changes in who is opening de novos. A “de novo” urgent care refers to a center that did not previously …

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How to Survive a Payer Review

How to Survive a Payer Review

Benjamin Barlow, MD; Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC One of the biggest challenges facing urgent care operators is increased scrutiny in the form of payer reviews. More clients than ever are facing these administrative and financial burdens. Compounding the issue is that urgent care clinicians often struggle to understand coding guidelines and how to document in a way that shows their medical decision making, which is vital in care and in payer reviews. Prepayment …

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The Challenges of Billing Out-of-Network

The Challenges of Billing Out-of-Network

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC One of the biggest challenges for an urgent care is billing insurance as a non-participating provider. When opening a new practice or adding a clinic, completed credentialing and contracting is essential and has a direct impact on the overall success for a new business. Opening without effective dates may result in cash flow shortages due to the fact that most health plans will not offer retroactive effective dates. Additionally, …

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