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Thread Topic: Free Standing Facility
Topic Originator: Jackie
Post Date July 25, 2006 @ 3:18 PM
Free Standing Facility

July 25, 2006 @ 3:18 PM Reply  |  Email Friend   |  |Print  |  Top

I have a pediatric office in Florida that want to open a 24/7 acute care center at the same location.  The facility will only be available for their patients and people traveling or in the area on vacation.  What would be the best credentialing?

Steve Verno
July 26, 2006 @ 7:48 AM Reply  |  Email Friend   |  |Print  |  Top

As a fellow Floridian, you do understand you will be in competition with other Urgent Care centers established by the major hospitals, so by restricting who you will treat, it may not be cost effective to be open 24/7.  How do you plan to handle an emergency that walks in that is not one of your patients or a tourist?  I take it you plan on doing a huge advertising campaign to attract the tourists. Plan on the negative publicity if a local is turned away.  They also talk to the tourists that visit our State.  Also, you will not be in the business of providing emergency medicine as defined under Florida Law, so most of your E/M codes will be 99201-99205/99211-99215.

You will need to contact the Florida Board of Health to have your facility licensed as an urgent care center.  

You will need to contact the Division of Corporations and have the new medical group registered as a corporation.

You will need a separate Tax ID number for the Urgent Care Center.

You will need to hire physicians, other than Pediatricians, to work in your facility.

You will need to have the urgent care center enrolled with Medicaid and Medicare as a new Medical Group.  Plan on that taking 8-12 weeks.

You will need to have the new physicians enrolled with Medicare and Medicaid.  Plan on that taking 8-12 weeks.

You will need to have the new physicians enrolled with the new Medicare and Medicaid Group numbers.  Plan on that taking 6-8 weeks.

You will need to establish EDI agreements with Medicare and Medicaid.  Send them test files so that you can send electronic claims.

You will need to contact the various insurance companies:  Aetna, Cigna, Humana, NHP, Careplus, Amerigroup, Vista, United, Wellcare and others to discuss the possibility of contracting with them, otherwise your urgent care center will be a non-participating entity.

You will need to speak with your malpractice carrier to have your new providers covered.

That should get you started.

July 26, 2006 @ 10:13 AM Reply  |  Email Friend   |  |Print  |  Top

Thanks for the information. This group is already established, however, they have expanded to after hour care for their patients in lew of ER.  The community is praising their efforts, an interview was presented by a local news station.  The owner also won the humanatarian award for his work in Bolivia and Africa.

They have observation rooms and treat children after hours, some of them stay 23 hours; however, they only bill for the pro fees.  They need to get paid for the drugs and supplies used.

Is there a better approach other than credentialling as a facility?

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