2021 E/M Guidelines: Your Questions Answered

It’s been 14 months since the new evaluation and management guidelines took effect. Many providers struggled to modify their documentation after 25 years with the 1995 guidelines. Urgent care practices stepped up with training programs to get through the learning curve with some new concepts. This month I’ll address some of the common questions that we receive. Do I have to meet the level in all the elements to bill a code? No, the level …

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Your Best Investment Is Growing Your Own Business

Your Best Investment Is Growing Your Own Business

Urgent message: Many urgent care operators took full advantage of opportunities to serve their communities during the pandemic, accumulating cash in the process. While many question what comes next, there’s no better time to grow your own urgent care business. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Senior Editor of The Journal of Urgent Care Medicine. On March 11, 2020, the World Health Organization declared COVID-19 a pandemic, and within …

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Our Readers Write—and Have a Lot to Say About ‘Toxic Positivity’

Our Readers Write—and Have a Lot to Say About ‘Toxic Positivity’

The January 2022 issue of JUCM led off with an editorial by Editor-in-Chief Joshua W. Russell, MD, MSc, FCUCM, FACEP about what he called “actually the epidemic that is decimating the healthcare workforce” and “a silent killer of healthcare careers.” He was referring to toxic positivity, or the practice of “encouraging” someone—in this case healthcare providers in the midst of the COVID-19 pandemic—to find and focus on the bright side rather than dwell on withering …

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Urgent Care Is Evolving, but Its Foundational Attributes Remain

Urgent Care Is Evolving, but Its Foundational Attributes Remain

In the article Your Best Investment Is Growing Your Own Business (page 25), Alan A. Ayers, MBA, MAcc makes the case that this could be an ideal time for urgent care operators to bet on their own future growth and success by investing back into their business. For one thing, the COVID-19 pandemic appears to be winding down in the U.S., with our industry having made tremendous progress in earning what Urgent Care Association CEO …

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What Else is New in 2022?

The Protecting Medicare and American Farmers from Sequester Cuts Act was signed into law on December 10, 2021. This law addresses the reduction in the 2022 Conversion Factor set by the Physician Final Rule, as reported in my December column, increasing the 2022 Conversion Factor by 3%. The new conversion factor becomes $34.61 compared to $34.89 in 2021. With the increase in Relative Value Units on most E/M codes, the impact to 2022 rates becomes …

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Once You’re in Court, Your Documentation May Be All That Can Save You

Once You’re in Court, Your Documentation May Be All That Can Save You

Sal D’Allura, DO, FAAFP “It’s lonely being the defendant in a medical malpractice case.” Truer words were never spoken. At some point in our careers, the majority of us will be named in a medical negligence case. The unfortunate reality is that medicolegal issues will arise as a part of our professional lives along with a multitude of negative emotions (which inevitably spill over into our personal lives) when we stand accused. These negative feelings, …

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In Spite of Turbulence, the Forecast Is Sunny for the Urgent Care Market

In Spite of Turbulence, the Forecast Is Sunny for the Urgent Care Market

No one would argue that the past 2 years have been easy for urgent care. First many operations were shut out of the running to receive adequate COVID-19 testing supplies. The same occurred in the early days after vaccine approval. Still, the industry adapted. Once testing supplies were available, operators established new procedures to maximize the number of patients could get tested safely and efficiently, whether that meant setting up in parking lots or  selecting …

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Can PAs and NPs Unionize in Urgent Care Settings?

Can PAs and NPs Unionize in Urgent Care Settings?

Urgent message: Urgent care’s workforce has changed from primarily emergency physicians to physician assistants and nurse practitioners now making up the bulk of providers. Whereas physicians historically have been excluded from joining a union, recent efforts to organize PAs and NPs have garnered media attention. While just over 10% of U.S. employees belonged to a union in 2019, a number of groups in industries that do not traditionally have a union presence have gone on …

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What’s the Best Policy for Unlocking an Urgent Care’s Doors when a Provider isn’t Present?

What’s the Best Policy for Unlocking an Urgent Care’s Doors when a Provider isn’t Present?

Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Senior Editor, Practice Management of The Journal of Urgent Care Medicine. Urgent message: Whether an urgent care must have a provider on-site during all operating hours comes down to the operator’s risk tolerance. As a matter of patient safety, many urgent care centers have adopted a policy that if no provider is on-site, they must lock the doors and refuse entry of any …

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Refunds: How to Avoid Them

Refunds: How to Avoid Them

Refunds have always been a challenge in healthcare. Not only do they create an administrative burden but there is also the potential for compliance risk. Some common causes for refunds are: Not validating the patient’s insurance eligibility and collecting the wrong copay amount Choosing a blanket amount to collect from all patients up front regardless of whether  they have insurance (ie, over collecting at the time of service) Sending statements too early, causing duplicate payments …

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