JOHN SHUFELDT, MD, JD, MBA, FACEP Chief Justice Roberts, writing for the majority, published the Supreme Court’s decision in National Federation of Independent Business v Sebelius on June 28, 2012. With a few exceptions, the decision upheld the bulk of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare. In the next few paragraphs I will attempt to make some sense out of the ruling and how, if applicable, it applies to …
Read MoreDeveloping Data: September, 2012
These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCAOA 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 MoreE/M Coding for Multiple Visits, Contracted Case-rate Billing, Comparing Payor Reimbursement Policies
DAVID STERN, MD (Practice Velocity) Q. We sometimes have patients who require two visits to clear impacted cerumen in their ears. In some cases, this procedure requires a 24-hour regimen to soften the cerumen prior to flushing the ear. How do we bill for the second visit and does it change how we bill if we find a second diagnosis after we clear the cerumen? A. For the second visit, you may code for all …
Read MoreDUI: Rules of the Road
JOHN SHUFELDT, MD, JD, MBA, FACEP Oh crap! The flashing red lights illuminating the interior of Eric’s car snapped him back to reality. He had lived through a tough year – passed his family medicine boards, finished residency, separated from his wife and ultimately went through a contentious divorce. Eric’s first post-graduate job ended poorly after he was caught up in owner infighting and left as the practice he joined dissolved. Suffice it say, Eric …
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Five Federal Employment Regulations Urgent Care Operators Need to Know (Part 2)
Urgent message: The second article in a two-part series looks at USERRA, FMLA, and NLRA—three federal labor laws that urgent care operators are likely to encounter. ALAN A. AYERS, MBA, MAcc Practice Velocity Case Record Urgent care centers are subject to a multitude of federal employment regulations and failure to comply with any of them could result in civil litigation or criminal penalties. Laws prohibiting discrimination, regulating wages and hours, permitting leave for military service …
Read MoreDeveloping Data: July/August, 2012
These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCAOA 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 MoreHospital Emergency Departments and Urgent Care Proximity, New vs. Established Patients using E/M Coding, Private Practice Urgent Care Coding
DAVID STERN, MD (Practice Velocity) Q. If a practice buys or opens an urgent care facility that is not in a hospital nor affiliated with a hospital, should we be using routine E/M codes for our visits? Secondly, do we have to follow the Emergency Medical Treatment and Active Labor Act (EMTALA) Guidelines? A. Yes. You should use the same E/M codes as used by the physician offices (990201-99215). EMTALA does not apply to urgent …
Read MoreOn Rock Bands, Plane Crashes, SWAT Teams and Codes
JOHN SHUFELDT, MD, JD, MBA, FACEP I’ve had the great pleasure of seeing Bruce Spingsteen and the E Street Band perform live a number of times since the mid-70s. Yes, I started being a “groupie” while still in diapers (no, not Depends). What amazes me still is the obvious teamwork among band members and crew. Bruce can change an introduction, set list, or song on the fly by simply looking a certain way at Roy …
Read MoreFive Federal Employment Regulations Urgent Care Operators Need to Know (Part 1)
Urgent message: As employers and managers of people, urgent care operators are likely to encounter situations that invoke federal labor laws. ALAN A. AYERS, MBA, MAcc, Experity Urgent care centers are subject to a multitude of federal employment regulations and failure to comply with any of them could result in civil litigation or criminal penalties. Laws prohibiting discrimination, regulating wages and hours, permitting leave for military service and family or personal health issues, and affecting …
Read MoreDeveloping Data: June, 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 …
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