VelociDoc Urgent Care Blog

Hospital-run Urgent Cares: New Modifier PD Applies to You

noreply@blogger.com (David Stern, MD, CPC) — Wed, 29 Feb 2012 17:40:00 +0000

Medicare has a new modifier for hospital-run urgent cares.

The new HCPCS Level II modifier PD is defined as “diagnostic or related non-diagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within 3 days, or 1 day.”

This new modifier is being applied as a part of CMS’ expansion of the “three-day payment window” for outpatient services provided within 72 hours of an inpatient admission.

What this means is that Medicare pays a reduced fee for services that are:

1) Clinically-related to an inpatient admission

2) Occur within 72 hours of the admission

3) Are provided by a facility owned or operated by a hospital

The rule applies regardless of whether the diagnoses codes are the same or different.

Although compliance with the Federal Rule is delayed until July 1, 2012, hospital-run urgent cares should begin using modifier PD on applicable claims now. CMS recommends that practices hold claims for at least three days prior to submission just in case the patient is admitted 72 hours later, which would necessitate the addition of modifier PD to the claim.

Hospital-run urgent care centers will be reimbursed the full amount for services that are “unrelated” to the hospital admission, but CMS has not provided a definition for non-diagnostic services that are considered “clinically related,” claiming that they prefer to make that determination on a case-by-case basis. For this reason, many urgent care consultants are recommending that clinics document the reasons why those particular clinic visits are “not clinically related” to the patient’s hospital admission to ensure they receive full payment.

For more information, see the November, 28, 2011 Federal Register.

Study Reveals E-Prescribing Increases Medication Adherence

noreply@blogger.com (David Stern, MD, CPC) — Mon, 13 Feb 2012 16:36:00 +0000

Are you still filling out paper prescriptions at your clinic? Study findings released this month by Surescripts, the nation’s largest e-prescription network (the network used by our VelociDoc EMR), show that you could be seeing higher first-fill adherence rates (i.e. new prescriptions that were picked up by the patient) if you switch to e-prescribing.

Surescripts worked with pharmacies and pharmacy benefits managers to analyze de-identified data sets that represented 40 million prescription records. They compared electronic prescriptions with paper, phone, and faxed prescriptions to determine if there is a measurable difference in first-fill adherence rates. What they found was a 10 percent increase in first-fill adherence when physicians used e-prescribing.

The graphic below illustrates an overly-simplified snapshot of their findings:

The study attributes this increase to two key factors:

1) Unlike paper prescriptions that don’t always make it to the pharmacy, electronic prescriptions are sent immediately from the doctor’s office to the pharmacy.

2) Patients experience less “sticker shock” because physicians are able to pull up a patient’s insurance information during the visit, so patients are not surprised by the cost of the medication when they arrive at the pharmacy.

According to the study, “the World Health Organization estimates that as many as 50 percent of patients do not adhere fully to their medication treatment.” Imagine the healthcare savings the U.S. could experience if we are better able to get our patients to adhere to medication therapy.

If you’re still filling out prescriptions by hand, maybe it’s time to make the switch to e-prescribing.

For more details on the study, click here.

For information on Practice Velocity’s VelociDoc EMR, which is integrated with Surescripts e-prescribing, click here.

Save the Date: Cirque du Velocity - April 18 - Las Vegas

noreply@blogger.com (David Stern, MD, CPC) — Wed, 01 Feb 2012 19:49:00 +0000

Planning on attending the spring UCAOA convention in Las Vegas? You might want to mark your calendar for Practice Velocity’s Cirque du Velocity dinner party event that will be held on Wednesday, April 18, at Caesars Palace in Las Vegas. More details will be forthcoming.

End of 2011, but Not End of Meaningful Use

noreply@blogger.com (David Stern, MD, CPC) — Fri, 27 Jan 2012 16:47:00 +0000

Now that 2011 is over, have you put meaningful use behind you? If so, you’re making a costly mistake. According to the January Urgent Care News story “EMR Experts: Start EMR Today and Still Get $44K,” 2011 was just the beginning for meaningful use. Physicians who qualify for the program still have a chance to get full stimulus dollars – that’s up to $44K per physician for the Medicare program. Be sure to check out the article for more information.

Here are some important dates for the Medicare program to remember as you head into 2012:

October 1, 2012: This is the last date for you to begin meaningful use of an EMR and still be eligible for the full $44,000 from Medicare. Since it takes several months to up to speed for full meaningful use, however, we would recommend that you start using your EMR no later than mid-summer, 2012.

December 31, 2011: This was the date the reporting year ended for the Medicare program in 2011. That means if you were planning on attesting for 2011, you must have completed your 90-day reporting period by December 31, 2011.

February 29, 2012: Even though the deadline to complete your 90-day reporting period was December 31, 2011, you actually have until February 29, 2012, to register and attest to receive payment for 2011.

ALSO....

CMS allows 60 days after December 31, 2011, for all pending claims to be processed, so February 29, 2012, is also your deadline for submitting pending Medicare Part B claims from calendar year 2011.
Remember: the Medicare program incentive payments are based on 75 percent of Part B allowed charges from visits that occurred in 2011. If you did not meet the $24,000 threshold in Part B allowed charges by the end of the 2011 calendar year, CMS expects to issue incentive payments in April 2012 for 75 percent of your Part B charges from 2011.

The Medicaid program is handled by individual states, so you must contact your state Medicaid agency for more information on your specific Medicaid program.

For more information on both programs, visit www.cms.gov/ehrincentiveprograms.

Get Free Advertising by Being a Healthcare Expert

noreply@blogger.com (David Stern, MD, CPC) — Wed, 07 Dec 2011 22:20:00 +0000

One of the tips I offer in my urgent care marketing video “How to Get Free Advertising” is to build good relationships with your local media by offering to be a local expert for any stories they might be doing on healthcare-related issues. Doing media interviews in which you offer your expert insights on a healthcare story, such as the importance of flu vaccinations, is great, unbiased exposure for your urgent care center. Not only will the local community start to view you as a healthcare expert, they will associate your urgent care center with expert healthcare providers. That kind of trust cannot be built through a TV or radio ad.

Shawna Ziegler, a nurse at Park Plaza Urgent Care in Omaha, Nebraska, took time out of her busy schedule to do a timely, relevant media interview about the dangers of falling on ice. In this TV news segment, Ziegler talks about the kinds of injuries she’s seen at Park Plaza Urgent Care and provides her expert advice on what people should do if they slip and fall on ice. Her appearance on the news segment created public awareness of Park Plaza Urgent Care and showed the public that the staff at Park Plazais knowledgeable and capable of handling this type of injury.

Dr. Douglas Blevins of Optimus Urgent Care in Greensboro, N.C., spoke to his local media about when it’s appropriate to visit an urgent care center versus a primary care doctor. The TV segment also included an interview with a patient at his urgent care center who spoke positively about her experiences at Optimus Urgent Care. This is a great testimonial for Dr. Blevins’ urgent care center because the patient offers her candid opinion to the reporter, not the urgent care’s marketing director. We’ve all seen marketing testimonials before, and we all know to take them with a grain of salt. The public will put far more trust in a testimonial provided through an unbiased media interview than a marketing video on your urgent care’s website.

You might think you don’t have time to do media interviews, and you’re partially right. You should certainly be selective of which interviews you agree to take. While you can’t control the angle the reporter takes with the story, you can at least ask the reporter what the story is about to attempt to ensure that the story won’t misrepresent you or your urgent care clinic. You don’t need to worry too much about this, as local news stations generally avoid conflict with local companies because they are part of your community and may want you to advertise with the station in the future. And remember: even if you turn an interview down, be polite and maintain that positive relationship with the reporter. If they are doing a story like the ones Ziegler and Blevins assisted with, you’ll want them to turn to you as a healthcare expert.

Do You Need an MBA for Startup Billing?

noreply@blogger.com (David Stern, MD, CPC) — Sun, 20 Nov 2011 21:23:00 +0000

I saw an ad for a biller today. It read, "______ Urgent Care (a recent startup) is seeking a Billing Director to support our central billing office and multi clinic operation. Complete revenue cycle knowledge a must. MBA preferred...."

Interesting! This urgent care decided to save money by doing their own billing. But now they realize that they need serious expertise--so much so that they are willing to hire an MBA (at $60-80,000) to manage their revenue cycle.

Early on with Practice Velocity, we actually encouraged startups to do their own billing, but we rapidly realized that this was a mistake. Doctors had their spouses do it part time. Others hired someone who had "done billing" for a doctor's office, but then learned the hard way that the person had simply entered charges from a superbill in a physician office. This so-called "biller" had no significant knowledge of the entire billing cycle, from contracting/credentialing, coding, electronic billing, electronic remittance, clearinghouse exception reports, denials, non-contractual discounts, audits, compliance, payor downcoding, and much more. A simple mistake in just one aspect of the billing cycle can cost a center 10% or more, and costly mistakes are inevitable when a novice is doing the billing.

Startups often decide to do their own billing to "keep control" and "save money." But what they quickly discover is that they don't have control of systematization, rather they own their own chaos. And the supposed money "savings" were overwhelmed by the losses incurred by the ineptatude of the novice biller.

This center has realized the truth: you do need a very high level person to manage the extreme complexities of revenue cycle management. However, few MBAs have any medical billing expertise, and crackerjack billers are hard to find and are just as expensive as an MBA. Our own urgent care centers struggled for more than 10 years until we were finally able to solve the problem with the appropriate expertise and finances. Finding and funding the necessary expertise for successful revenue cycle management with an internal billing department is a classic conundrum--you need true expert billers for financial success, but until you have financial success, you can't afford true expert billers.

That is why we took our seasoned billers from our urgent care centers and turned them into a billing company (PV Billing) to help centers focus on providing excellent medical care and growing their business while we took care of the revenue cycle management.

It has been extremely gratifying to see more than 100 successful startups use PV Billing as a tool for success. We have been delighted to see so many startups rapidly open a second -- some even a third -- urgent care centers within two to three years.

Our motto at PV Billing is simply this: "You take care of patients; we'll take care of the rest." It is great to see it work so well for so many.

Week in Review: Urgent Care Awareness Week

noreply@blogger.com (David Stern, MD, CPC) — Fri, 18 Nov 2011 19:52:00 +0000

It was very heartening to see urgent cares across the country join the public awareness efforts of Urgent CareAwareness Week over the last few days, including sharing links to UCAOA’s website www.urgentcarecenter.org, offering discounted flu shots, posting urgent care factoids on Facebook, and submitting press releases to their local media. Educating the public, including primary care physicians and EDs, is crucial to ensure the important role urgent care plays in our nation’s healthcare is fully understood.

Urgent Care Awareness Week concludes on Sunday, so as Practice Velocity’s contribution to such an important awareness campaign, I’d like to offer a recap of the five 2-minute videos we shared throughout the week. Each video offers a tip on how to maximize your urgent care’s marketing efforts. We hope they help you get your message out there.

UrgentCare Marketing Tip #1: How to Make Facebook Work for You

Are you getting the engagement you expected on your urgent care’s Facebook page? If not, you might be making these common mistakes. Watch tip #1 to learn how to make sure your Facebook page is not boring.

UrgentCare Marketing Tip #2: How to Get Involved in Your Community

It might seem like you have no time to get involved in your community, but the truth is that it’s not only possible to get involved, it’s also crucial if you want your patients to feel you are approachable and trustworthy. Watch tip #2 to learn how to get started.

UrgentCare Marketing Tip #3: How to Get Free Advertising

Did you know you might be passing up free advertising for your urgent care? It’s hard to believe, but many urgent cares are doing just that. Watch tip #3 to learn how to make sure you’re not missing out on quality exposure for your practice.

Urgent Care Marketing Tip #4: How to Get YourBillboard Noticed

So you’re spending thousands of dollars on a billboard for your urgent care. Are people even noticing it? Watch tip #4 to learn how to design a billboard that’s going to grab the public’s attention.

Urgent Care Marketing Tip #5: How to Be a “Guerrilla” Marketer

The public is inundated with marketing messages everywhere they go. Are your marketing messages reaching them? Watch tip #5 to learn how to be a “guerrilla” marketer without resorting to tactics that are shocking or in poor taste.

Great Marketing Tips from Dr. Stern for Urgent Care Awareness Week

noreply@blogger.com (David Stern, MD, CPC) — Fri, 11 Nov 2011 15:00:00 +0000

Are you participating in the fourth annual Urgent Care Awareness Week next week? If so, Practice Velocity wants to collaborate with you. We want to showcase your efforts to reach out to your local communities. Send us your photos, news clippings, videos, etc., and we’ll post them to our Facebook page at http://www.facebook.com/practicevelocity.com.

You can submit via email to Mika Doyle, Communications Coordinator, at mdoyle@practicevelocity.com.

In addition to helping you get your Urgent Care Awareness Week message out, Practice Velocity will be offering daily videos starting on Monday that feature urgent care marketing tips and ideas to help you amp up your marketing campaigns. There are several ways you can access them:

Daily email blasts (Click here to subscribe)
Daily on Facebook at http://www.facebook.com/practicevelocity
Daily on YouTube at http://www.youtube.com/practicevelocity
A Friday digest on Practice Velocity’s blog at http://www.urgentcareblog.practicevelocity.com

If you don’t know about Urgent Care Awareness Week, it’s not too late to participate. This nationwide campaign facilitated by UCAOA is November 14-18 and is aimed at increasing public awareness of the urgent care industry and the role it can play in the nation’s healthcare. UCAOA is encouraging urgent cares to get involved by using their turnkey kit to reach out to their local communities and legislators. Be sure to check out their kit and try to pick at least one method of getting involved.

And don’t forget to “Like” our Facebook page so you don’t miss all of the great Urgent Care Awareness Week posts we’ll be sharing.

Register to Win an iPad 2 at UCAOA

noreply@blogger.com (David Stern, MD, CPC) — Mon, 17 Oct 2011 17:56:00 +0000

In just a few days several Practice Velocity team members will be in Dallas for the Urgent Care Association of America’s fall conference. It’s an exciting time of year for us because we get a chance to catch up with colleagues and connect with people we haven’t had the pleasure of meeting yet.

We’ll have a lot of exciting stuff going on at our booth, so we hope you stop by sometime during the conference. Here are a few reasons you should come see us:

I will be giving live demonstrations of the VelociDoc^® EMR.
Register to win an iPad 2.
Schedule free one-on-one consultations with me.
Schedule free one-on-one consultations with other members of the PV team.
Learn about our products and services, including the new features that came out in our latest release.
Ask our urgent care experts any questions you might have about the industry, about starting an urgent care, and/or about running an urgent care.

Whether you’ll be in Dallas or not, you can also stay connected with us throughout the conference through Twitter and Facebook. We’ve been posting Q&A interviews with our staff on Facebook so you can get to know some of the faces behind PV, and during the conference we’ll be posting updates, photos, and key takeaways from some the classes. If you haven’t already joined us, check us out at:

See you in Dallas!

Every1Matters at Practice Velocity

noreply@blogger.com (David Stern, MD, CPC) — Wed, 12 Oct 2011 15:34:00 +0000

This morning the Practice Velocity staff was greeted with a peculiar site: balloons were peeking over the walls of every single cubicle in the building. It was quite a spectacle, and the staff had no idea that the celebration wasn’t just for the company as a whole – it was for each and every one of them as well.

You see, we reached a milestone this month at Practice Velocity, and today we took a moment to celebrate our success with the people who helped make it happen: our team members.

As of this month, Practice Velocity is now serving urgent care centers in 49 states. Fairlight Medical Center in Williston, North Dakota, came on board with us last week, becoming the first North Dakota clinic we have served. We now serve clinics in every state except South Dakota.

We are so thankful to all of our great customers for choosing Practice Velocity, who we couldn’t support or serve without the great team we have on staff. To reflect our appreciation of all who have touched our lives, today we unveiled our #1 core value: Every1Matters.

Every1Matters means every single team member, every single contact, and every single customer matters to Practice Velocity. At PV: I matter, we matter, you matter, every1matters.

As a gift to our team, we gave each of them a tumbler reflecting the Every1Matters message so they have a daily reminder that they matter.

We all gathered together in one of the conference rooms and enjoyed some apple cider and apple cider donuts from a local orchard. To see photos from today's celebration, visit our Facebook page to view the the photo album.

Celebrate National Health IT Week by Switching to an EMR

noreply@blogger.com (David Stern, MD, CPC) — Wed, 14 Sep 2011 17:00:00 +0000

President Obama has declared September 11-16, 2011, as National Health IT Week. Has your practice made the transition from paper to electronic charting yet? Making the change may seem like a daunting task, but the benefits of using an EMR over paper charts are immeasurable.

Here are my top 10 reasons you should consider switching to an EMR:

10. Faster documentation: There are no loose papers to sift through with an EMR. Chart quickly and efficiently, with all of your patients’ records readily available.

9. Reduction in errors: It’s far more difficult to make serious charting errors with an EMR, especially with those that feature built-in alerts.

8. Prevent lost records: EMR’s securely back-up your patient files.

7. Streamlined patient flow: Documenting visits faster and keeping better track of your patients with an EMR will streamline your patient flow and allow you to see more patients in less time.

6. Readily available data: Every healthcare provider needs timely access to their patient records, but this is crucial for practices with multiple locations. An EMR securely stores your patient records so you can access them from any of your clinic locations.

5. Grow your practice: With faster documentation and streamlined patient flow, you will easily be able to see more and more patients, growing your practice and increasing your revenues.

4. Protect your patients’ personal health information: An EMR will allow you to securely store patient information.

3. Increased revenues for your practice: If you choose an EMR designed with your specific practice in mind, your coding should be optimized to the specialized needs of your practice.

2. Improved patient experience: All of the above benefits contribute to a better experience for your patients, which is every healthcare provider’s #1 reason for entering the field.

1. Get government stimulus dollars: There is no better time than now to implement an EMR that has been ONC-ATCB Certified to help your physicians qualify for government stimulus dollars. If you implement in the next few months, you can still get all $44,000 per physician.

There’s never been a better time to make the switch from paper charting to an EMR. I encourage you to do your homework and choose a system that fits the specific needs of your practice.

If you’re interested in learning more about Practice Velocity’s EMR solution, request a free demo today.

"If you don’t have a meaningful web presence, you don’t exist."

noreply@blogger.com (David Stern, MD, CPC) — Sun, 11 Sep 2011 17:02:00 +0000

The quote above is attributed to Mark Britton, CEO of AVVO . Is it really true for urgent care centers? Note: he is not speaking about simply having a website, he is talking about a presence in social media?

Of course it is hyperbole, but there is real truth in this statement. For millions of Americans the phone book and the yellow pages are anachronisms, similar to the horse and buggy. In many communities, people search for their healthcare services on the Internet.

If your urgent care is not on social media, you are practically invisible on the Internet to people under thirty. If you want to argue with the "invisible" word, that's fine. Let's say instead, that you are missing out on a great opportunity to interact and attract this population.

Of course, some argue that social media is just a fad that will come and go like the hula hoop. That's fine but the fad is here. Others argue that they would rather go with traditional advertising in newspapers and radio. Go ahead. But traditional advertising is very expensive and every year it offers less effective results.

What if someone had come up to you when you first opened your urgent care and offered to give you a product that would allow you to not just advertise, but to fully engage and interact with thousands of people in your community? Would you not have paid over $10,000 for the product? It is called social media; it is available now; and it is FREE.

So how should you respond? You don't need to do everything at once. It probably makes sense to just start with a single option and go from there.

Facebook: Get a Facebook page and interact with people and businesses in your community. Let you community know that you care. Get active and stay active. Check out these examples of urgent care centers that are using Facebook effectively: Acute Kids (over 4,000 "likes" as of today), NextCare, Health Now, and Urgent Care Niagara. Remember, Facebook is not just another webpage for your business. Facebook is a place where you can interact with your community and your patients.
Twitter: I admit only a few urgent cares get it on Twitter, but the ones that are using it are daily reminding in front of hundreds of patients that their urgent care centers are there to serve them. See Doctors Express PDX, Irvine Urgent Care, Urgent Care Manhattan, and Mission Urgent Care.
Blog: Adding a blog to your website is a great way to keep your site fresh and interesting to visitors. Your blog is not likely to be the most interesting and provocative healthcare website on the Internet, so that should not be your goal. Instead, find issues in your community related to disasters, safety, parenting, immunizations, infectious disease outbreaks, etc. that have a local angle and are truly interesting to your specific community. This will allow you to put a personal and personable face on your urgent care center. FastMed's blog does this well. Sonny Sagar of Downtown Urgent Care in St. Louis dares to be interesting without always being local. However, very few urgent care blogs are worth reading, and beware of the dead blog--a blog that hasn't been updated for months or years.

Your posts will be dated, and a website that keeps a stale Facebook, Twitter, or blog page online will simply look like the business does not pay attention to details. Worse people may assume that the folks at the urgent care simply don't care.

For another perspective on social media in medicine, listen to Dr. Mike Sevilla discuss how to use social media for physicians at AAFP Convention in Orlando.

But if you get involved and engage your patients and your community, social media can be a very effective way to serve your community and grow your urgent care.

Thank You to the Great Staff at Practice Velocity

noreply@blogger.com (David Stern, MD, CPC) — Fri, 29 Jul 2011 19:48:00 +0000

I have always felt that being a business owner is a rewarding experience, but when I arrived at the office this morning, there was something there waiting for me that blew all past awards and distinctions out of the water. Sitting right there on my desk was a gift and an anonymous thank you card from the PV staff:

The “Bombshizzle” reference might seem odd, but Practice Velocity has what we’ve named a “Bombshizzle Award” that is bestowed upon staff members who are nominated by their supervisors for oustanding performance.

This is one of the highest honors I have ever received. I want to thank my staff for all that they do. I am incredibly grateful to have the opportunity to work with each and every one of them.

The Recession Can’t Stop Practice Velocity

noreply@blogger.com (David Stern, MD, CPC) — Wed, 27 Jul 2011 21:20:00 +0000

It’s amazing to look back and recall Practice Velocity as an idea – an intangible concept that had yet to be realized – but less than 10 years ago, it was just that. I was working in urgent care with my two partners, Dr. John Koehler and Dr. Terry Buzzard, and we shared a frustration with the effectiveness of the nitty-gritty aspects of running our practice, such as billing, coding visits, maintaining a good patient flow, etc. When we began researching software that could help us get organized, it didn’t take long for us to realize that there really wasn’t anything out there that met the specific needs of an urgent care practice. We weren’t satisfied with using software that was designed for a different specialty because it created much unnecessary work and frequent work-arounds. So we went with the best option we had available: we created our own.

We founded Practice Velocity in 2002, and our first customer went online with PiVoT^®, our modified electronic medical record, in February 2003. Today we have a full line of services to offer urgent care practitioners, including a full EMR, practice management software, billing services, and contracting and credentialing services.

And we certainly serve more than just the original urgent care client (I sure am grateful they took a risk and came on board with us in those early days). Our first customer is still with PV today, and we now serve more than 750 urgent care centers in 48 states.

That’s a lot of growth in less than 10 years! Our staff has had to grow tremendously in order to help us keep up, and this month we reached a milestone: we hired our 200th employee. We are humbled to have been able to grow jobs during such a severe recession, and we feel incredibly lucky to be able to work with such an amazing team of people.

Thanks to all of our customers for helping us grow to where we are today, and a special thanks to Marge Simat and Long Island Medical in New York – the very first urgent care clinic to use Practice Velocity.

Practice Velocity has come a long way in such a short period of time, but we’re not done yet! We expect to see more growth in the coming years as more and more urgent care centers look to improve patient care and streamline processes through urgent-care-specific software.

Avoid Medicare Penalties by Implementing an EMR

noreply@blogger.com (David Stern, MD, CPC) — Wed, 06 Jul 2011 14:17:00 +0000

The regulations for meeting meaningful use in order to get government stimulus dollars have been causing significant challenges for many physicians. Most recently, the June 30 deadline for implementing e-Prescribing (eRx) has come and gone, and those who missed the deadline should receive a 1% penalty on all Medicare payments in 2012. I say “should” because, although it’s now too late to code the 10 visits with G8553, CMS is actually giving physicians a second chance to avoid penalties.

That’s right – if you missed the June 30 deadline, you can breathe easy because CMS has proposed a revision to the eRx portion of the Medicare EHR Incentive Program that, if adopted (which we fully expect), will allow physicians to meet the eRx requirements by fully implementing a certified EMR before October 1, 2011, and attesting to meaningful use. This is in addition to several somewhat obscure exemptions that allow for a little more wiggle room in the program. Read the CMS Fact Sheet on the proposed rule.

What does this mean? Well, if you thought it was too late to implement an EMR in your practice, think again. You now have until October 1 to adopt and implement a certified EMR. Not only will this allow you to access up to $44,000 in stimulus dollars, you will, also, be able to avoid Medicare eRx penalties.

Practice Velocity’s VelociDoc® Tablet EMR version 11.01 is 2011/2012 ONC-ATCB Certified by CCHIT®. If you’d like more information on how the experts at Practice Velocity can help your urgent care center get government stimulus dollars and increase your practice’s profitability, schedule a free demo today.

Choosing the Wrong Stimulus Program Could Cost You 10K or More

noreply@blogger.com (David Stern, MD, CPC) — Thu, 30 Jun 2011 15:07:00 +0000

I recently received a question from the executive director of an urgent care center regarding the difference between the Medicare EHR Incentive Program and the eRx Incentive Program, which are both being offered by the Centers for Medicare and Medicaid Services (CMS). Her group has four full-time physicians, but they only do about $40,000 total per year with Medicare. Because physicians can only participate in one of the two programs, she wondered if it would be more beneficial for her practice to go for the eRx bonus instead of the EHR bonus.

While it might seem like $40,000 in Medicare charges is not enough to garner much in stimulus money, crunching the numbers reveals it really would be advantageous to go for the EHR stimulus program. With the EHR program, eligible physicians can receive up to 75% of their Medicare allowable charges over the course of 5 years for a total of up to $44,000. However, with the eRx program eligible physicians can receive only 1% of their allowed charges in 2011 and 2012. Take a look at the figures:

EHR stimulus: 75% x $40,000 = $30,000
eRx stimulus: 1% x $40,000 = $400

That’s a difference of $29,600! Simply put, do not disregard the EHR Incentive program because you could be missing out on up to $44,000 in stimulus dollars. Registration opened in January, and you have until 2012 to receive maximum payments. It’s important to note that there are Medicare penalties after 2015 for physicians who do not demonstrate meaningful use of EHR technology, the main component of the incentive program.

For more information on the EHR Incentive Program, download a whitepaper produced by Practice Velocity.

Practice Velocity’s EMR is certified to meet meaningful use criteria for the EHR Incentive Program. View our certification details and schedule a free demo today.

Urgent Care Clinics Have 2 Days to Post Prices in Lobby

noreply@blogger.com (David Stern, MD, CPC) — Wed, 29 Jun 2011 20:50:00 +0000

Florida urgent care centers have until Friday to install signs in their reception areas that list the prices of their 50 most frequently provided services. The mandate is part of HB 935, which was approved by Florida Governor Rick Scott on June 2. Urgent care centers that don’t comply by Friday will face some stiff fines – up to $1,000 per day until they get those signs up.

State Representative Richard Corcoran (R), who sponsored the bill, says the goal is to provide patients with transparency in the cost of their healthcare. In media interviews, he has even gone so far as to say he expects this bill to be a stepping stone to making the cost of healthcare services more accessible to patients – a lofty goal given that healthcare services are not as easily priced as, say, the menu items at a fast food restaurant. As any physician will tell you, there are many different factors that contribute to what each patient is charged for their visit. In the case of urgent care, proper codes for visits cannot even be determined until:

after the doctor has evaluated the patient,
ordered tests, and
selected treatment.

It would seem to be more helpful to the public simply to note that the “typical visit” (i.e. median) costs $94 and note that costs may vary depending on tests, treatments, and severity of illness.

To my urgent care colleagues in Florida, I wish you all the best in meeting the requirements of this bill by the end of the week.

Open Forum for Urgent Care Professionals Launches

noreply@blogger.com (David Stern, MD, CPC) — Wed, 22 Jun 2011 14:20:00 +0000

If you go to any urgent care conference, meeting, gathering, etc., you’ll quickly learn that urgent care professionals are, for the most part, exceptionally open to sharing their knowledge of and experiences in starting and/or running their own urgent care centers. There truly is this spirit of “coop-etition” in which we are always cognizant of the competitiveness of running a business but vividly remember the struggles of being a novice urgent care center in a growing industry.

While willingness to share is certainly not a problem among urgent care professionals, opportunities to engage each other in those conversations are few and far between. Schedules are hectic, and time is always at a premium. However, the value of these conversations cannot be overstated.

That’s why we at Practice Velocity decided it was vital to create a public forum for urgent care professionals to connect with each other outside of the convention circuit that is accessible to anyone with an interest in urgent care – from those who are simply considering a transition to urgent care to urgent care veterans. To achieve this end, we have launched an online forum designed to allow urgent care professionals to connect with each other that is convenient, easily accessible, and free.

Urgent care professionals can access the forum at www.practicevelocity.com/forum. Anyone can view the forum threads, but in order to post a question or an answer, you must register as a user. For those who are on facebook, you can log in with your facebook credentials, which speeds up the registration process and eliminates the need to create a brand new username and password to remember. Users who log in with their facebook credentials also have the option of sharing their favorite threads with their facebook friends.

To kick off the forum, I have added 170-plus answers to questions I have received from others in the urgent care industry. I invite you to explore the plethora of topics that are currently open for discussion and encourage you to join the conversation by asking your own questions and posting your own answers.

For those who prefer a more private discussion arena, the Urgent Care Association of America (UCAOA) offers a highly professional members only forum. Current UCAOA members can access the forum by signing into the UCAOA UConnect Portal. If you’d like to get more information on joining UCAOA, visit the membership page on their website.

We’re excited to be able to offer this new, free tool to urgent care professionals. The forum is currently live, so check it out today at wwww.practicevelocity.com/forum and start connecting with your industry peers!

Learn How Meaningful Use Applies to Urgent Care

noreply@blogger.com (David Stern, MD, CPC) — Wed, 25 May 2011 14:05:00 +0000

I mentioned in my last blog post that I would announce the date and time of a webinar I’m offering on the basics of the Medicare EHR incentive program. The details of the webinar have been finalized; it will be held from 1 to 3 p.m. CDT today (Wednesday, May 25).

During the webinar, I will provide an overview of the Medicare government stimulus program for EHR implementation. I will also review the stimulus program and how it applies to urgent care using Practice Velocity’s VelociDoc^® Tablet EMR as a practical example of how you can use an EHR to capture those dollars for your practice.

Here’s a snapshot of the details:
What: FREE Webinar – “EMR Meaningful Use for Urgent Care”
When: 1 to 3 p.m. CDT Wednesday, May 25
You will learn:
• The basics of the incentive program
• Who qualifies
• What the regulations are
• How Practice Velocity’s VelociDoc^® Tablet EMR meets those regulations
• How to sign up for the stimulus programs
How to register: Click here to register

Get Paid by Uncle Sam to Use Our EMR

noreply@blogger.com (David Stern, MD, CPC) — Tue, 17 May 2011 21:28:00 +0000

Practice Velocity has just announced that the VelociDoc® EMR has been ONC-ATCB certified by CCHIT®, the most reputable organization for medical software certification. Review VelociDoc's full certification details on our website.

In the past year, Practice Velocity has been inundated with questions about the government incentive programs offering stimulus dollars for demonstrating meaningful use of electronic health record (EHR) technology. The programs are especially vexing for those in urgent care because they were designed with primary care practices in mind, creating a slew of challenges for the industry.

We at Practice Velocity understand what’s at stake: up to $44,000 in stimulus dollars for the Medicare program. In the future, providers who have not implemented meaningful use of an EMR will incur penalties in Medicare reimbursement. Thus, our development team has been working hard to update the VelociDoc® urgent care EMR and PVM^SMPractice Management software to comply with the meaningful use criteria.

I’ll be offering a webinar on the basics of the Medicare incentive program in the coming weeks, so watch out for announcements on how to sign up. Until then, please feel free to click the button below to download a whitepaper presented by Practice Velocity that provides an overview of the programs.

ACEP Attacks Dr. Stern's Editorial

noreply@blogger.com (David Stern, MD, CPC) — Wed, 27 Apr 2011 16:40:00 +0000

The American College of Emergency Physicians (ACEP) responded to my recent blog post “American College of Emergency Physicians Attacks Urgent Care” with a vigorous rebuttal. ACEP has attacked my editorial anonymously, stating “this blog post is a deliberate misreading of both the TIME article and ACEP’s position. ACEP never attacked urgent care centers or said anything about them.”

I would absolutely agree that urgent care was not mentioned, and this is exactly the problem. As I stated in my reply to ACEP (click the link above and scroll down to the comments), ignoring urgent care in the conversation is an “attack” by omission, much the same as having a polite discussion in your living room but ignoring the elephant sitting in the corner sipping tea.

Additionally, I find it interesting that the TIME editorial notes the “marginal cost” of seeing patients for minor problems in the ER, but the anonymous ACEP representative admits in his/her comments that ER “individual [patient] bills are high.” The ACEP representative goes on to defend these hefty bills by saying they help cover the cost of treating patients who don’t pay their ER bills.

So is ACEP saying it’s acceptable to make other patients responsible for these unpaid bills? Why not reduce the cost of staffing ERs by directing unnecessary visits to a place designed specifically to handle non-emergency injuries and illnesses: an urgent care clinic?

It’s preposterous that ACEP is not educating the public on ALL of their options, whether it is primary care, the ER, or an urgent care clinic. It’s an absolute disservice to the public to insinuate that after-hours illnesses or injuries that are not life-threatening require a long and costly visit to the ER or a wait until the patient’s primary care physician’s office is open.

But don’t just take my word for it – I encourage you to read the TIME Magazine editorial, as well as my editorial (linked above), and judge for yourself.

32-Clinic Urgent Care Chain Sold

noreply@blogger.com (David Stern, MD, CPC) — Fri, 15 Apr 2011 21:18:00 +0000

Urgent Care News sent out a Newsflash yesterday about Florida Governor Rick Scott’s sale of his shares of Solantic, the Jacksonville-based chain of urgent care clinics he founded in 2001. Although news reports credit the deal to increasing questions regarding conflicts-of-interest with healthcare changes the governor is trying to pass, the Urgent Care News article illustrates this sale is yet another in a growing trend of large investment companies pushing their way into urgent care.

Click here to read the Urgent Care News article.

American College of Emergency Physicians Attacks Urgent Care

noreply@blogger.com (David Stern, MD, CPC) — Wed, 13 Apr 2011 14:10:00 +0000

Urgent care physicians have long urged payors to encourage patients to use the much less costly alternative to the hospital emergency department. Payors around the country are finally figuring this out and developing active programs to divert patients with non-emergency problems to urgent care centers. You won’t even believe the response of the American College of Emergency Physicians’ (ACEP). Instead of applauding this effort to reduce health care costs and unclog overcrowded emergency departments, ACEP has begun an active campaign to establish the importance of ED visits for patients with minor problems.

A TIME Magazine editorial, published in partnership with CNN on Monday defended the American College of Emergency Physicians’ (ACEP) for "launch[ing] a campaign to derail proposed policies to reduce the use of emergency departments (EDs)." The editorial, written by two emergency physicians Drs. Jesse M. Pines and Zachary F. Meisel, argues that efforts to steer patients away from visits to the ER in order to drive down health care costs in the U.S. are misguided and devalue emergency medicine because these efforts miss what the headline calls “the real value of emergency care.”

Is this just simply self-interested nonsense, or is it an authentic effort to maintain what is good about our healthcare system?

Drs. Pines and Meisel say that “some emergency care could probably be avoided if there were adequate alternatives, like clinic doctors who are responsive to their patients’ urgent needs. But the fact remains that for many there are no convenient alternatives to EDs.” Nonesense! The USA has over 8,500 “convenient alternatives.” They are called urgent care centers, and they are overwhelmingly staffed by “clinic doctors who are responsive to their patients’ urgent needs.”

So do the doctors discuss the urgent care alternative? No; it might seem incredible, but the words “urgent care” do not appear even once in the TIME editorial. One must wonder if the doctors thought that by ignoring the viable “alternative,” urgent care would somehow disappear from the debate.

Even the examples selected show their extraordinary bias. They mention “a young woman with an uncomfortable urinary-tract infection on a Saturday.” What a perfect case for a visit to an urgent care center! Instead, the editorial describes the woman’s sole alternative to an ED visit on Saturday as “wait[ing] until Monday when the doctor's office is open.”

Drs. Pines and Meisel state that retail clinics are “typically built in rich suburbs,” so they are not available across the country in small towns and big cities. Are they unaware of urgent care centers that in recent years have rapidly been opening in small towns and urban areas? As far as the lack of viable alternatives in poor urban areas, does that mean that the ED is the right place for treating these non-emergency issues? Maybe, instead, it means that CMS needs to focus on efforts to fund urgent care centers in poorer neighborhoods, where overuse of hospital EDs is an even bigger problem and the need for less costly alternatives to the ED is critical.

They, also, argue that hospital EDs are important because they are open 24 hours a day. Indeed, few urgent care centers are open 24 hours. But most urgent care centers do offer significant evening and weekend hours, and very few non-emergency problems need treatment outside of the typical urgent care center hours of operation: 8AM – 8PM. True emergencies should absolutely be treated at a hospital ED, and urgent care providers are quick to send emergency cases directly to the ED. But for those after-hours issues that require immediate treatment but are not life-threatening, urgent care centers are a great alternative.

Drs. Pines and Meisel obfuscate by waxing eloquence for the importance of the hospital ED as a place for treatment of the “entire cross-section of human illnesses.” Are they really serious? The hospital emergency department is designed, staffed and ideally suited for the treatment of emergency conditions—not the “entire cross section” of medical conditions.

The editorial goes on to state a ridiculous reason for patients to utilize the hospital ED for minor problems: “The fact is that nobody knows if they are having an emergency when they go in [to an ED] ... We all need to recognize the value of figuring it out, explaining what the problem is and providing reassurance...” Just because of the outside chance that my sore throat is an emergency, should I go to an “emergency” department? What nonsense! In my over 20 years of practicing urgent care medicine, I have only transferred a few patients to a hospital with true emergencies, and I have never had a single patient code in the urgent care. With very few exceptions, people have proven themselves quite capable of triaging true emergencies to hospital EDs.

More concerning is Drs. Pines and Meisel’s statement that the “marginal cost of an ED visit is actually lower than that of an off-hours clinic visit.” What? Are they saying it costs less to be treated in a facility that costs more than twice as much per square foot to construct and uses doctors and nurses who are paid twice the salaries of urgent care physicians and nurses? Forget about the intentionally confusing (and questionably accurate) statistic of “marginal cost;” what is the cost to the insurers and the patient? The truth is that emergency departments generally charge patients three times the fees for the same services in an urgent care center. If the marginal cost of an ED visit is so low, why not reduce ED charges by 60%? Then the ED would really be a cost neutral alternative to urgent care.

An informed reader will note that the editorial does not marshal a single valid argument for payors to cut their public awareness programs for urgent care. If an urgent care center was readily available in every single community in the USA and if patients were aware of the proper use of such centers:
• then hospital EDs could focus on what they do best—care for emergencies
• and then patients could get what they need most—appropriate, timely and economical care for their medical conditions.

If all patients don’t currently have ready access to urgent care centers, then the editorial simply underlines the fact that the USA still does not have enough urgent care centers.

Payors have every reason to educate patients as to the value of urgent care. Patients have a right to know that they do have an alternative to the ED for non-emergency medical problems that need timely treatment. In fact, this knowledge will inevitably drive down health care costs, when patients begin choosing the cheaper, more convenient and more cost-effective alternative—urgent care.

How One Urgent Care Clinic is Giving Back

noreply@blogger.com (David Stern, MD, CPC) — Wed, 06 Apr 2011 21:31:00 +0000

For most U.S. citizens, it’s difficult to imagine not having access to the bare minimum in health care. Yes, health care and its costs have been a topic of hot debate in the U.S. for quite some time now, but at least we have the option of debating what our options are. There are some places in the world that consider another day free of disease or death good health care.

Regardless of your stance on the current state of health care in the United States, it’s impossible to argue against the fact that the U.S. is exceptionally fortunate to have the resources we do in comparison to third world countries. One Practice Velocity customer recognized the urgent need for quality health care services in India and set out to help its residents receive the medical attention they are currently lacking.

Dr. John J. Koehler of Physicians Immediate Care (PIC) based in Rockford, Ill., realized that, while India’s urban middle class has ready access to health care, there are at least 135 million rural and tribal people who lack the bare minimum in health care. In fact, many people die before they are able to reach a hospital. Dr. Koehler made it his mission to utilize his urgent care experience and expertise to construct a Physicians Immediate Care clinic in Beulah City, India, which is surrounded by 70 villages in need of access to quality medical services. Through several years of hard work and dedication, Dr. Koehler is closer than ever to realizing his dream, as the clinic is projected to be dedicated in July of 2011.

It’s easy to get caught up in the nitty-gritty of everyday life and forget how fortunate we really are. Congratulations to Physicians Immediate Care for seeing such a worthy project come to fruition.

For more information on this exciting project, including how to get involved, visit http://www.physiciansimmediatecare.com/about_us/givingback2.php.

Practice Velocity’s ZipPASS Goes Mobile

noreply@blogger.com (David Stern, MD, CPC) — Thu, 24 Mar 2011 15:07:00 +0000

We’re excited to announce that Practice Velocity’s ZipPASS® service has gone mobile with a new partnership with Healthagen, the developer of the leading mobile consumer health care application iTriage. Surpassing more than one million downloads in a 12-month period in January of this year, iTriage is in the top one percent of all health care apps in all mobile markets.

This unique health care app allows users to input their symptoms to make a self-assessment, then provides recommendations on where to go for treatment, such as the ER, an urgent care center or retail clinic, or a primary care physician. The app also provides contact information and directions to health care providers in the user’s area. Smart phone users can download it for free at the Apple iTunes App Store or at the Android Marketplace.

Practice Velocity’s ZipPASS service is a web-based portal that offers patients the ability to schedule urgent care appointments from the comfort of their own homes, allowing them to “get in line, online” through the urgent care center’s website. Instead of waiting to see a physician in the urgent care’s waiting room, patients are given a specific appointment time and can wait wherever they choose, as long as they arrive at their scheduled appointment time.

With this new partnership with iTriage, patients won’t even need to be at a computer to schedule their ZipPASS appointment. In addition to the plethora of services the iTriage app already offers, patients can now use their smart phone to locate the nearest urgent care center and schedule an appointment.
The addition of the ZipPASS function to iTriage offers a tremendous value to patients, who use the app for their medical needs, as well as urgent care providers, who can experience greater efficiencies within their practices by utilizing the ZipPASS service.

If you haven’t seen Healthagen’s official press release on this partnership, click here to read it.