The Affordable Care Act was established to make it possible for people to receive medical attention without fretting over costs all the time. Urgent Care Centers are some of the services that the provisions have permitted. These centers are designed to handle cases of acute emergencies the same way ERs do. Over 150 million people have access to urgent care centers in different parts of the U.S., and their roles have also increased significantly over the last few years.
The nation’s shifting policies in health care have expanded the functions that urgent care centers have to play. For this reason, the regulation of services offered by acute care has become necessary. It means that more people have eyes peeled to the actions of everyone working in these centers. Another downside to the increased scope of work is that these institutions have become more complex.
The medical practitioners working in urgent care centers have to handle more responsibilities. That makes it easier for them to commit errors when delivering services. You may have ended up in a legal situation due to your work at an urgent care center. Besides workers, the center itself may get in trouble for some violation or other. Some of the legal issues that acute care centers face are unique to the healthcare sector, which is why the expertise of a specialized attorney would be invaluable.
Some Possible Legal Troubles
As with all healthcare providers across the country, urgent care centers in Houston have to face the threat of malpractice or negligence suits. These cases are the most prevalent in the industry and have cost institutions millions of dollars. For individuals, the revocation of a practicing license is enough to have you looking for an attorney.
Billing errors are other challenges that these entities may encounter now and then. With all the work that medical workers have to deal with, these mistakes may occur more often. Some of these include:
• Use of the wrong diagnosis codes
• Failing to sign orders for treatment
• Billing for services that are not included in the Operating Certificate of the center
• Failing to identify the right provider on a claim
• Billing for a service where treatment was denied because it was not considered medically necessary.
Cases of Medicare, Medicaid, and insurance fraud are other legal complications that an acute care center may come across. With federal law making provisions for ordinary citizens to bring forth fraud cases, the risks are very high. A simple billing error or miscalculation may land a medical practitioner or the whole center in hot water.
Corporate practice of medicine is frowned upon for many reasons. The premise is that when non-professionals get involved, they can degrade the quality of care provided by these centers. Due to this, regulations are established to keep corporations away. Violations may include abuse of self-referral laws, kickbacks, fee-splitting and fraud.
What a Lawyer Can Do
An urgent care center getting investigated for fraud brings unnecessary scrutiny into all its activities and employees. Even when accusations are baseless, it is the authority’s duty to ensure everything is in order. Complaints to a regulatory board can be particularly scary to deal with. It is even more challenging when you are named in a complaint individually. A legal professional can provide assistance when navigating these uncharted territories. You get someone who can help you muddle through the red tape.
Early intervention can save you or the center a lot of money. By getting a Houston urgent care center lawyer, you can evaluate your options. Proper representation can make a huge difference, especially in serious cases such as fraud, malpractice, and negligence.
The regulations for urgent care centers are varied in different states, and that will impact your case in several ways. Even the defense strategies available may differ. The region also dictates the penalties applied to various offenses if found guilty. A lawyer in Houston understands the implications of each type of case. Whether a case gets dismissed or proceeds, having legal representation gives you peace of mind.
Besides defending you or an urgent care center, an attorney can help set up policies and compliances for workers to reduce cases of billing errors, misconduct, and other violations. A proper compliance plan can be very effective in ensuring that an institution adheres to state and federal mandates.
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During the past decade, the number of urgent care centers has grown significantly. There are some medical issues, regulations, and legal issues these centers are facing. They remain a very popular choice for quick and easy medical care.
Urgent Care Center
This is a type of walk-in clinic. It is focused on treating illnesses or injuries that require immediate care. These are medical situations that may not be serious enough to require a visit to a hospital’s emergency room. They may provide the same type of services as ambulatory healthcare centers such as a convenient care clinic and more.
The Urgent Care Association of America (UCAOA) has determined what criteria an urgent care center must meet. They must accept all walk-in patients during regular business hours. The center must be equipped to provide treatment for a variety of illnesses and injuries. They must also be able to perform minor medical procedures. A licensed physician must hold the position of medical director. The must have multiple exam rooms and a variety of diagnostic equipment on-site and more.
Many people continue to go to an urgent care center when they aren’t able to get to a hospital or other type of healthcare facility. In many situations, individuals won’t get the same level of care they experience when going to a hospital. The goal for care at an urgent care facility is speed. They want to get a patient finished with the registration, evaluation as well as treatment and discharge process within sixty minutes or less.
An urgent care center is subjected to audits that cover a wide range of risk areas. This includes third party payers as well as Medicare and more. It may be important to have experienced legal representative appeal an audit finding when necessary. They can also help during different levels of an audit appeal process. There are some substantive, procedural as well as strategic issues involved with having a successful audit defense. An experienced attorney will know how to draft position papers and write submissions designed to have a successful audit experience.
It may be beneficial to have an attorney help an urgent care center when it comes to drafting and negotiating their employment contracts. They will know how to identify issues that may cause problems with the urgent care center in the future. This involves non-solicitation as well as non-compete provisions and more. Audit risk assessment and some other issues are also important to have in an employment agreement.
Changes in the medical field can happen quickly. Many new regulations may require the help of a legal professional to fully comprehend. Too many times urgent care centers are more focused on dealing with providing healthcare to their patients, and not spending a sufficient amount of time focused on all of the latest regulation in their industry. An attorney will be able to keep an urgent care center aware of all the latest regulations and how to follow them so litigation can be avoided.
It is important for an urgent care center to maintain all proper documentation. Treating physicians need to be careful to thoroughly chart each important aspect of a physical examination. This is required and essential to avoid problems should a lawsuit occur. Legible handwriting is essential as is properly making notes, checking appropriate boxes as well as completing template charting. This creates the type of medical documentation that is defensible in court and can withstand the scrutiny of medical experts.
Not An Emergency Room
A person should not go to an urgent care center expecting the same level of care as an emergency room. Urgent care centers are usually staffed by physicians. Emergency room departments are staffed by specially trained emergency physicians. An emergency room will have access to diagnostic services such as labs, specialists such as surgeons, cardiologists and others who can provide specialized care. An urgent care center is not designed to provide this.
Emergency Medical Treatment
An urgent care center may have to meet the requirements of the Emergency Medical Treatment and Labor Act (EMTALA). This applies to hospitals with dedicated emergency departments. It requires these departments to provide certain services to patients in an emergency situation. Should an urgent care center be owned by a hospital or a joint venture with a hospital, it may be necessary to meet EMTALA requirements. An attorney will be able to assist and help an urgent care center comply if it is required to follow EMTALA regulations.
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