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Below is a list of questions that urgent care centers have asked us.
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1. My partners and I are going to start an urgent care in California. Are there any publications that you offer that may help answer the many questions that we have with regard to starting an urgent care? Read Full Question and Answer
2. I just read in the recent JUCM, the Q&A on "Addressing Problem - based Coding and Other Challenges" and it sparked my interest with a new code. It is the first time that I have heard of the S9088 code. Read Full Question and Answer
3. I came across your name and company while searching for an urgent care practice opportunity. I am currently working in a medical center and likely will be leaving due to contract changes. I am board certified in Family Practice and also run a center in New Hampshire. Read Full Question and Answer
4. If our clinic has an urgent care that is advertised as such and is open after hours, should we be using POS 11 or 20? Read Full Question and Answer
5. I am part owner of a free standing urgent care center. Our community is dominated by medicare and managed care plans. We have only been able to negotiate flat rate payment from most of our managed care payors as we have little bargaining power. Read Full Question and Answer
6. I am a family practice physician in West Virginia and typically moonlight 4 days a month in local ER's. Our privately owned family practice is next door to our local hospital where I can get x-rays conveniently. Read Full Question and Answer
7. I am a new family medicine physician and I am in the brain storming stage of planning to open a Sports Medicine/Family Practice /Urgent care office with a Emergency Medicine colleague of mine. Read Full Question and Answer
8. I saw your article in the JUCM and I was wondering if you could help with a question. I am currently developing a Performa for an Urgent Care we are considering for late 2008. Read Full Question and Answer
9. I just visited www.practicevelocity.com, and found it very interesting. I am interested in gathering as much information as possible on urgent care centers and all that is involved in a startup of an urgent care center. Read Full Question and Answer
10. I learned a lot from your lectures and comments. I would like to ask you to send me a spreadsheet fee analysis and sample cost savings sheet. Read Full Question and Answer
11. What are your thoughts on charging the S9088 code? We currently charge $82, which usually drops to patient responsibility - most insurances are not recognizing it. We currently take the specialty co-pay - and coupled with the S code, patients end up paying around $100 out of pocket. Read Full Question and Answer
12. Would you tell me what CPT code would be the appropriate code to use for a follow-up visit for strep? This patient came in initially for sore throat, the strep test was negative. Read Full Question and Answer
13. Is the definition of 'new' or 'established' different in the case of a hospital based urgent care center? Read Full Question and Answer
14. Are there Standard Practice Guidelines for an Urgent Care or Walk In Center? If so, where would they exist? Read Full Question and Answer
15. I am doing some research on Urgent Care settings and would appreciate any resources or suggestions for learning the top billing codes in an urgent care setting. Read Full Question and Answer
16. I am new to coding for urgent care. My background is primary care. I have some questions about codes 99051 and 99058. 99051 -- Is there a true definition for evening or should I just use for 5:00 and later? Read Full Question and Answer
17. My office has started to provide Urgent Care and we were wondering if because this is Urgent Care, our services should be reimbursed at a higher price than for our Family practice services? Read Full Question and Answer
18. I have a group of ED physicians that are thinking about opening an urgent care clinic in the area. They feel it can be a good return on investment and increased quality of life. Read Full Question and Answer
19. I have been speaking to a local hospital that does not have a pediatric ER. The employees at the hospital have to go to another ER for their children. When I spoke to the person in charge of this at the hospital they were very interested in contracting with my center. Read Full Question and Answer
20. You reinforced our initial impression that in Florida, the standard reimbursement plans are on the flat-fee model. We will be approaching the major insurers in the next few weeks, Read Full Question and Answer
21. What matrix (demographics, economics, infrastructure) are available to assess whether or not a community will support an Urgent Care Practice in Southern California? Read Full Question and Answer
22. I just read your article in the May edition of JUCM, which, by the way, was most informative. Can you tell me what dollar amount might be a reasonable amount or national average for payors to reimburse for the 99050 and 99051 codes? Read Full Question and Answer
23. I have been moonlighting at an ucc for the past 2 years and now the owner has made me an offer to buy the ucc. I am hoping to solicit your advice to whether you think the price is a fair one. Read Full Question and Answer
24. I had been doing some research on the use of Code 99051 and then I opened the most recent Journal Of Urgent Care Medicine. Read Full Question and Answer
25. My clinic is open to walk-ins during all open hours which are 8-8 m-f and 9-5 on Sat and 1-5 on Sunday. We have lab and x-ray at all times. Read Full Question and Answer
26. We are a new urgent care clinic (6 months). I have read several articles on billing and coding practices for urgent care centers, including your column in The Journal of Urgent Care Medicine. Read Full Question and Answer
27. I am in the process of starting up an Urgent Care Center in Rhode Island. I am an internist/id doc, with plenty of ambulatory experience and plenty of experience working in urgent care centers. Read Full Question and Answer
28. We will begin billing for a free-standing urgent care facility shortly, and have been told that the doctors providing services in the facility are not required to have their names on the claim forms, but only the facility as that is the provider. Read Full Question and Answer
29. Can I use a Nurse Practitioner as a locum provider? How long can they practice? Do we have 60 days to credential them the same as physicians? Read Full Question and Answer
30. I was interested in more information on the "S" Codes. I do have a question though concerning the following: How does clinic licensing/certification effect the reimbursement for the facility? Read Full Question and Answer
31. A new patient comes in with a laceration, I still bill the E&M visits with a modifier 57, because we are billing a surgery code on the same day, not a modifier 25, unless we did do something other than the laceration. Read Full Question and Answer
32. I have a question for you guys. I work as an NP for a large chain of free standing private urgent care clinics here in florida. We do have x ray capabilities, see walk in urgent care, perform physicals, and see various workers comp. patients. Read Full Question and Answer
33. I have a question. Do you routinely send out for wound or urine culture and sensitivity? Read Full Question and Answer
34. I have a question for you. We are a Family practice center, with an Urgent Care emphesis. We are having a hard time with billing. Read Full Question and Answer
35. Dr. Stern, I enjoyed reading your artile "How to Define a Type B ED" in a recent JUCM journal. I have a question I would greatly appreciate an answer to. I am the medical director of a number of hospital owned urgent care centers. Read Full Question and Answer
36. We have recently opened our first urgent care and there has been some disagreement on charting. Is there a location to find documentation on the required charting for an urgent care? Read Full Question and Answer
37. I was wondering if you can give me a code to begin with to review with the Blue Cross Contracting department for payment needs for a urgent care facility that we operate. Read Full Question and Answer
38. In reading your Q & A answer in the Feb. 2007 JUCM the criteria you listed for type B emergency depts is also the criteria definition as to whether UCC meet EMTALA requirements. Read Full Question and Answer
39. Do you have any experience in dealing with Urgent Cares who work under the license of hospitals? Read Full Question and Answer
40. I am a new coder for an Urgent Care located in Texas. I am excited about learning anything and everything about urgent care. Thank you for the article on when to use the modifier 25. Read Full Question and Answer
41. Was wondering if this would be a good place to startup urgent care 1) Growing retail area with lots of new houses, 2) Urgent cares, 4 in town next to this, Read Full Question and Answer
42. Can you tell me what guideline is being used for compliance when the physician signs off on the statement of "I certify that I have reviewed all of the data on all pages of this form, and I deem the exam clinically appropriate for this visit?" Read Full Question and Answer
43. I am a RN currently working in my town's local ED. I am working towards my Masters. My ultimate goal is to be a nurse practitioner in adult health or acute care. Read Full Question and Answer
44. May I ask what CPT code you use to perform a Wood's Lamp Evaluation to diagnose or not diagnose a Corneal Abrasion? Read Full Question and Answer
45. I work for a doctor who is trying to find out what the urgent care codes are. Could you tell me where to find this information in the CPT book and what code range? Read Full Question and Answer
46. My question is what ICD-9 code, other than a fussy baby can be used when a parent brings in a child. Read Full Question and Answer
47. I am looking for some information on structuring the ownership of an urgent care center to permit not physician owners. Read Full Question and Answer
48. I'm a certified coder working for St. Louis Connect Care Urgent Care Center. It was brought to my attention that we may not be billing E/M visits correctly. Read Full Question and Answer
49. I was wondering if there is any way that I am able to obtain records regarding the number of patients an average urgent care physician sees per shift. Read Full Question and Answer
50. I am looking for a set of pre-printed patient discharge instructions. Read Full Question and Answer
51. We are attempting to pull some equity out of the value of our facility but are having a tough time finding business comps for a Professional Urgent Care. Read Full Question and Answer
52. I am looking for information regarding opening an Urgent Care Facility in Georgia? Read Full Question and Answer
53. I was wondering if you could tell me what you expect from your providers as far as number of patients seen per hour per provider. Read Full Question and Answer
54. Do you have figures of the average salaries for PA's in Urgent Care? Read Full Question and Answer
55. We would like to begin using S9088 and are currently checking reimbursement. Read Full Question and Answer
56. We have enjoyed our initial 8 months of operation and are looking forward to opening our second clinic in August. Read Full Question and Answer
57. I stumbled onto your website in my frustrated search for an improved practice style, and am interested in what you might have to offer. I own my own family practice (and the building). Read Full Question and Answer
58. I have been working in the health care community for the past 6 years as I have been achieving my current status as a BSRN in one of the busiest Emergency Departments. Read Full Question and Answer
59. How easy is it to get the Insurance Co. to recognize you as a health care organization? Read Full Question and Answer
60. I recently took a job at an Urgent Care Center and realized when we billed an E&M code with other codes such as 90772, 94760, 94664 and 99173 they will bundle. Read Full Question and Answer
61. I’m writing to you today to inquire about your recent presentation “Blending Occupational Health and Urgent Care” of which I unfortunately was not able to attend. Read Full Question and Answer
62. We bill for 4 clinics that are licensed as "outpatient clinic". We are confused on the place of service code because the 22 states the facility is part of the hospital... Read Full Question and Answer
63. The meeting in Chicago was most informative in October as was the tour of your urgent care facility. My medical director and I were talking about the possibility of us getting trained... Read Full Question and Answer
64. I am trying to open an urgent care center in New York and am having difficulty finding regulations. Do you have any information that may be useful? Read Full Question and Answer
65. I have a place 20'x50'. Could this be adequate to start an urgent care center? Read Full Question and Answer
66. The agency that I work for is located in North Carolina. We presentaly provide Hospice, Home Health and Mental Health Service. Read Full Question and Answer
67. Our corporation is building a new business/office complex with plans to include a Urgent Care. Read Full Question and Answer
68. Is there an established method of valuing an Urgent Care business for the purchase of a purchase/acquisition? Read Full Question and Answer
69. How is it determined to charge for drugs admin in urgent care? Read Full Question and Answer
70. I want to know if you have some good suggestions and input for negotiating a contract with insurance company. Read Full Question and Answer
71. We are interested in finding out information on your software mainly focusing on rooming of patients (time to room), discharge instructions, and documentation. Read Full Question and Answer
72. What is required by the state of New York to open an Urgent Care Facility? Read Full Question and Answer
73. I am in search of documented information to validate or negate a billing question. Read Full Question and Answer
74. Are many urgent care clinics started by mid-level providers... Read Full Question and Answer
75. Do you carry software that allows patients to sign-in electronically? Read Full Question and Answer
76. I have been considering opening an urgent care facility as a non Physician for some time now. Read Full Question and Answer
77. I am thinking of changing my 8 month old internal medicine clinic into an urgent care center. Read Full Question and Answer
78. In your blog you stated to use $100-$110 as a net per visit at an urgent care. Read Full Question and Answer
79. I am planning to open an Urgent Care in a downtown metropolitan city in Missouri by January 2009. Read Full Question and Answer
