Questions for Dr. Stern
About Your Urgent Care Center
13. Is the definition of 'new' or 'established' different in the case of a hospital based urgent care center? To further clarify - if we have a patient seen in another of our outpatient clinics, or a patient that was an inpatient in the recent past, and that patient shows up in our urgent care center - my understanding is they would be a new patient since they have not been treated in our urgent care center for the presenting problem. Is this a correct interpretation?
Most people use the TIN to determine NEW vs EST. If you are billing out under the same TIN as the hospital or other outpatient clinics, the question would be if any physicians (of the same specialty) have billed for physician services under this TIN. Of course, this is quite unwieldy to track, so many hospitals simply set up a separate TIN for the urgent care center. Sometimes, however, this is difficult, due to issues surrounding maintaining a non-profit status for all entities. Also, if the patient has been seen by a particular physician (in any setting) it does not matter what TIN is used, then the patient is established with that physician. I hope this answers your questions. Feel free to call me about any of these issues.
