K Royal, JD, CIPP/E, CIPP/US Urgent message: The shift in medical practice from written charts to integrated digital platforms has dramatically increased the visibility, size, and magnitude of health-care information breaches. There are specific steps urgent care operators should take with vendors to protect patient information in this new technological environment. The news makes it seem that data breaches occur on a fairly regular basis. The Ponemon Institute even named 2014 as the year of …
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Improving the Patient Experience by Thinking Differently About Waiting
Urgent message: Attracting and retaining urgent care patients entails more than reducing the total duration of patient waits. It also requires understanding and managing patient expectations and perceptions of waiting. MICHAEL BURKE, MBA, and GARRETT BOMBA, MD People often respond irrationally in waiting situations. How else can we explain the fact that people are routinely more satisfied with a clearly explained 30-minute wait than with an uncertain 20-minute wait? It is not rational, but it …
Read MoreTop 3 Blood Tests Performed at U.S. Urgent Care Centers in 2014
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded visits by patients to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, reveal that the top 3 blood tests performed at U.S. urgent care centers in 2014 were as follows, in descending order: • Comprehensive metabolic panel—3.15 million tests • Glucose level—1.23 million tests • Thyroid-stimulating hormone level—1.19 million tests The survey’s methodology and data abstraction forms …
Read MoreOpen Fracture Treatment Versus Closed Fracture Treatment
Q. We had a patient come in with an open fracture of the distal interphalangeal joint of the right index and middle fingers, ICD-9 [International Classification of Diseases, 9th Revision, Clinical Modification] code 816.12. The provider set and splinted them both. Can I bill procedure code 26765 (“Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each”) twice? A. A diagnosis of open fracture means that the skin has been …
Read MoreTop Procedures Performed at U.S. Urgent Care Centers in 2014
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded visits by patients to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, reveal that the top 3 procedures performed at U.S. urgent care centers in 2014 were as follows, in descending order: • Medication administration (vaccine, IV, steroid injection, anesthesia)—59.7 million procedures (39.8% of visits) • Rapid diagnostic tests and cultures—44 million procedures (29.4% of visits) • …
Read MoreProtecting Patients and Assets: Pre-employment Background Checks and Drug Screening
ALAN A. AYERS, MBA, MAcc, Experity A number of patients who had been dispensed the narcotic hydrocodone called the urgent care center to complain that their medications “weren’t potent enough,” that they “didn’t work,” or that the pills in the bottle “didn’t match the description on the label.” Although these reports were initially dismissed by the medical director as drug-seeking behavior, the volume and corroboration of complaints soon led to an internal investigation. It turned …
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Investment Trends in Urgent Care: A Mergers and Acquisitions Roundtable
Urgent message: Urgent care is a highly fragmented industry considered ripe for consolidation. A handful of high-profile deals have made 2015 the biggest year for mergers and acquisitions yet, but high valuations, oversaturated markets, changing buyer and seller expectations, and structural changes attributable to the Patient Protection and Affordable Care Act will influence urgent care deal-making in coming years. ALEXANDER NATHANSON, MD Mergers and acquisitions (M&A) in the U.S. urgent care industry have historically consisted …
Read MoreElectrocardiogram Data Points and Evaluation and Management Visit Level; Gait Training
Q. When counting data points for the complexity of medical decision-making (CMDM) portion of the evaluation and management (E/M) visit level, what is the correct way to assign data points for an electrocardiogram? For example, the Current Procedural Terminology (CPT) code is 71020 for a chest radiograph with interpretation and report. The description itself has the interpretation and analysis included in the code already. Is it considered double-dipping if we count the interpretation as 1 …
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Implications of Patients Recording Urgent Care Provider Encounters
Urgent message: The ubiquity of smartphones increases the risk that patients will openly or covertly record interactions with their physicians. Urgent care operators should understand the legal and privacy implications and protect themselves with appropriate policies and training. ALAN A. AYERS, MBA, MAcc Practice Velocity Smartphones with cameras and audio and video recorders that can be easily concealed in a pocket, purse, or backpack are now used by roughly 71% of Americans, including 86% of …
Read MoreFractures in ICD-10-CM
Q. We treat a lot of fractures in our urgent care clinic, and I understand there are changes for coding these in ICD-10-CM [International Classification of Diseases, 10th Revision, Clinical Modification]. What will we need to be aware of? A.Most of the changes made in ICD-10-CM were to chapter 19, “Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88),” because of the need to identify laterality and 7th-character extensions that indicate the type of …
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