Journal of Urgent Care Medicine

Medical Professional Liability Insurance: Limiting Cost While Maximizing Value

Urgent message: Liability insurance premiums continue to rise across the spectrum of medical practice environments. Urgent care practitioners can maximize the value of every premium dollar spent by understanding whom and what the policy actually covers. Terrence P. Coughlin, CPCU, ARM, AIC One of the more important andcostly aspects of running an urgent care center is the insurance coverage needed to protect the center and the medical staff working there. In recent years, all medical …

Developing Data: March, 2007

UCAOA’S Survey Committee drew two important conclusions from its first industry-wide survey: urgent care is a growing industry nationwide, and those within the industry are hungry for benchmarking data. In each issue of JUCM, Developing Data will seek to fulfill that need. In this issue: Typically, urgent care providers are physicians/entrepreneurs. But they come from a wide variety of practice environments—family practice, emergency medicine, etc.—so what’s the breakdown of how urgent care practices are structured, …

Code Compliantly But Differently, Based on the Payor

DAVID STERN, MD (Practice Velocity) Q.I have been told that I can get credit for a complete review of systems (at least 10 systems) by simply noting positive findings in certain systems and then noting “all other systems negative.” A.This is, indeed, a general CMS “guideline,” but two Medicare carriers have issued contradictory guidelines. TrailBlazer Health Enterprises (Medicare carrier for Delaware, the District of Columbia, Maryland, Virginia, and Texas) and Wisconsin Physicians Services (Medicare carrier …

Leveraging Existing Relationships to Generate More Business

FRANK H. LEONE, MBA, MPH Urgent care clinic operators tend to think of increasing employer-generated volume primarily in terms of new prospects; that is, they tend to believe that growth is attained primarily by expanding their client base. But in many cases, there is as much—if not more—opportunity inherent in selling additional services to existing clients. And “cross selling” to existing clients is just one of many potential advantages that your clinic can accrue by …

How to Define a Type B ED—and Other Vexing Questions

DAVID STERN, MD (Practice Velocity) The urgent care practitioner may not live by coding alone, but proper reimbursement depends on it. To that end, Dr. David Stern, who is in great demand as a speaker and consultant on coding in urgent care, will offer answers to commonly asked questions in every issue of JUCM. In this issue, he addresses a potpourri of issues raised by urgent care practitioners. Q.A consultant tells us that we have …

What to Do When You Get Named in a Malpractice Suit

JOHN SHUFELDT, MD, JD, MBA, FACEP Your front office receptionist informs you that there is a man at the door who says he is a process server, and that he wants you to sign for a registered letter. Your first thought, of course, is to run out the back door of your office or to simply feign a stroke. Instead, common sense prevails and you sign for the letter informing you that you are a …

Developing Data: February, 2007

Type of Structures Housing Urgent Care Clinics

UCAOA’S Survey Committee drew two important conclusions from its first industry-wide survey: urgent care is a growing industry nationwide, and those within the industry are hungry for benchmarking data. In each issue of JUCM, Developing Data will seek to fulfill that need. In this issue, who owns, who leases, and where are they located?More than half (53%) of the survey participants own the buildings in which their practice is located; 47% lease. The average business …

Coding Conundrum: E/M with a Procedure

Q.We always get denials for the E/M code in addition to a procedure. Are we doing something wrong? A.Denials for payment for an E/M in addition to a procedure may stem from several sources: Missing modifier If you perform a procedure with a 0- or 10-day global period and you perform and document a separate E/M on the same day, always attach modifier -25 to the E/M to reduce denials and costs of rebilling. Use …

Protecting Yourself Against Medical Malpractice Claims, Part 2

In the December issue of JUCM, Dr. Shufeldt introduced a discussion on how to not be named in a malpractice suit by suggesting that providing excellent customer service, never saying “no” to a patient, and thorough documentation of the pertinent positives and negatives are viable techniques to reduce your malpractice exposure. Here, he continues the discussion with other precautions you can take. Failure to make an appropriate referral is a reason commonly cited when providers …

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