Questions for Dr. Stern

About Your Urgent Care Center

87. How successful have you been with getting the MCOs to approve Problem-Based Coding (PBC) in your urgent care clinics and which MCOs have been agreeable to PBC?

In general, we use PBC as a negotiating strategy to spend time educating payors as to the additional expenses of urgent care and the value of urgent care to the MCO.

Since our urgent care centers have optimized E/M coding with Practice Velocity software solutions, we don't find that PBC makes that much difference.

Thus, we usually let them say "no," and opt for a better fee schedule instead.  We do have PBC in a few contracts, mainly with large local payors.

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David Stern, MD, CPC CEO, Practice Velocity Partner, Physicians Immediate Care Board Member, Urgent Care      Association of America Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

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