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When you think about the people who work in an urgent care center, you probably think of doctors, nurses and lab technicians. The center is a place that is similar to an emergency room, but you can often be seen faster and for minor ailments as well as those that are a bit more bothersome. Most of the same types of services are offered at an urgent care center that are offered at a doctor’s office or hospital. It’s the best of both worlds for many people, but there are times when the workers don’t always abide by the regulations that are set forth in the state. When the workers don’t provide the proper care and don’t uphold the regulations, then an attorney might be needed. An attorney can help a worker, whether it’s a nurse or a doctor, understand the consequences that are involved with the decisions that have been made. One of the common reasons why someone would need an attorney is after writing prescriptions that get more money from insurance companies. The doctor would write a prescription for a medication that is a higher price than what is required and work with the pharmacy to dispense a less expensive brand.
With the high number of people who are going to urgent care centers compared to primary care doctors, there is a possibility for more billing issues, which is another reason that those who work for an urgent care center would need an attorney. Caution needs to be taken when working with patients and when information is entered into the computer system so that the proper insurance company is billed and so that the proper amounts are billed for instead of those that are exaggerated. If there is any hint at an urgent care center being dishonest, then there is a chance that the federal government could step in and take over the center or fine some of the workers who are there. If the charges are severe, then there’s a possibility that workers could lose their license or have it suspended. An attorney can look at the facts that are in place and go over all the paperwork that the center has turned in to see if there was anything deliberately done or if there was a simple mistake.
One of the reasons an urgent care center would be investigated is because of billing for services that aren’t authorized. The center might not have the proper equipment to perform the services that are billed for, or the center might provide services while being closed. Some centers are only allowed to offer certain services, such as laboratory work, and if the center bills for anything else, then there could be issues that arise with the medical board in the state. Sometimes, treatment is determined that it wasn’t medically necessary. If the center still bills for those services, then it could be fined.
Centers often don’t identify the correct provider or try to submit two claims with two different providers who are in the center. This would mean to more money for the company and a possible kickback for the person who submitted the billing information. There are certain codes on healthcare forms that need to be submitted to billing companies. Sometimes, the codes are checked off in a manner that would mean more money for the center. Most codes are consolidated if multiple services are performed, resulting in the billing company not paying as much. However, if the center doesn’t use these proper codes and checks off each service individually, then it would mean a larger bill that is paid by the insurance company or government agency. An attorney will look over the case that is set forth, giving details on what could happen to the center if the issues are not fixed.