Developing Data: April, 2013

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). In …

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Primary Care in the Urgent Care Setting, E/M Codes With Other Services, Penicillin Injection

DAVID STERN, MD (Practice Velocity) Q. Can physicians see regular patients and schedule routine care at urgent care facilities? If so, can the urgent care center bill for those services at a separate, lower rate than the urgent care rate? A.Special attention should be paid to payor contracts in these situations. If the insurance company views your patient’s visits as urgent care even though you provided primary care, the patient could be responsible for higher …

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It Seemed Like a Good Idea at the Time

JOHN SHUFELDT, MD, JD, MBA, FACEP Have you seen poster with the phrase, “IT COULD BE THAT THE PURPOSE OF YOUR LIFE IS ONLY TO SERVE AS A WARNING TO OTHERS?” Have you ever had “one of those days” where you believed the poster was a sign from God directed only to you? Over the years I have heard hundreds of patients and numerous friends and acquaintances mutter the phrase, “It seemed like a good …

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Modifier -25 and Urgent Care Codes

DAVID STERN, MD (Practice Velocity) Q. Can a patient be billed for an E/M code and an ultrasound procedure such as 93970, “Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study” during the same visit when both the scan and the E/M visit were performed by the same provider? A. If during an office visit it is determined that the ultrasound procedure needs to be performed on the same …

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Developing Data: March, 2013

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). In …

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Language Interpretation Services in the Urgent Care Center

Language Interpretation Services in the Urgent Care Center

Urgent message: Cultivating trust requires good communication and if a language barrier stands between patient and provider, not only are clinical outcomes jeopardized, but the urgent care operation can be subject to legal liability. ALAN A. AYERS, MBA, MAcc Practice Velocity The demographics of the United States are rapidly changing. Today a language other than English is spoken in 55 million households, 67% of which speak Spanish, and an estimated 19% of Americans have Limited …

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Et tu, Brute?

JOHN SHUFELDT, MD, JD, MBA, FACEP In the past, when I have broached the topic of employee theft with urgent care owners, their typical, somewhat indignant, response is, “My employees would never do that!” I really like this answer because I really value loyalty – more than anything. In the film Ides of March, campaign manager Paul Zara (Philip Seymour Hoffman) proclaims: “I value loyalty over everything.” Of course, he completely gets screwed (by his …

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Developing Data: February, 2013

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCAOA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). In …

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S9083, Radiology, and E/M Codes

DAVID STERN, MD (Practice Velocity) Q.Can CPT code S9083 be billed with an E/M service code or would this be considered double dipping? You would not typically add CPT code S9083 to an E/M service unless instructed to do so specifically by an insurance company. CPT code S9083, “Global fee urgent care centers,” would be used in instances where the insurance company has stated that the reimbursement is based on a flat rate (global fee …

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Continue CPR! or How to Save the Patient and Screw the Pooch1

JOHN SHUFELDT, MD, JD, MBA, FACEP So there I was (all good stories start this way), having just participated in saving a 58-year-old guy who collapsed while playing golf with his buddies. It was a classic v-fib arrest—dropped after hitting a great drive right down the middle of the fairway. The man’s friends started CPR, paramedics arrived and shocked him out of VF into a sinus rhythm and intubated him. While in the emergency department …

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