ER followup visits and BP checks

[rnrn]

Hi, everyone! This is my first time posting to the forum, but I've read a lot of interesting things here.

Here's my question: How do your ERs handle followup visits and BP checks? I've worked in a few ERs, mainly rural, and whenever we needed patients to return for wound checks or suture removals, we would just add a progress note to the original chart without any additional charge. We also did BP checks as a courtesy when and if we had time, and then get them registered, if needed. The place I work now requires all patients to register before being seen by any licensed staff. That means a new copay everytime. Most of you are probably thinking this is not such a bad thing. This usually happens on the weekends, though, when there isn't a PCP available to followup. I would personally rather jot a quick note on a progress report than do all the paperwork involved in a triage and assessment and discharge. I've looked up some legal sites, but can't find anything. So if anyone knows the legal aspects of this, or just has some information on what the standard of practice is out there, please let me know. Thanks.

[debbyed]

Short Follow-ups - for things like wound check and suture removal we initiate a progress note. Short Triage to assess the wound etc. with vital signs. Registration logs them in on seperate follow-up log and there is no charge. Progress note sent to Medical Records to be attached to original ER record.

Long Follow-up - Full Er record with full triage. Used for patients seen with-in 24 hours for same problem. Charging depends on amount of care given and supplies used. We use this style due to the potential for some of these patients to be admitted if original therapy not working. ie: unrelieved vomiting/diarrhea, kidney stone that is not passing.

BP checks - done as courtesy..after all other patients waiting have been triaged. Recommendations based of the Red Cross/American Heart Association recommendations. No documentation unless patient decides to register to be seen.

Hope this helps.

[kaycee]

All returns to the ER for any F/U are registered. triaged, seen by the MD and charged. Wound rechecks, suture removals, packing removal ect.

We encourage folks with HMOs to see their PCP's for all rechecks, especially suture removal. I know the charge is minimal for all these things, and there is little or no reimbursement from insurance co.'s.

BP checks are a courtesy also and are documented only by the pt. on their little BP card if they have one. They sign in to be seen only if they want too which is rare.