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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Articles by From the College

Help Rheumatology Research Foundation Hit Its Year-End Goal: $100,000

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The Rheumatology Research Foundation is the charitable arm of the ACR, advancing research and training to improve the health of people living with rheumatic disease. Thanks to the continued support of ACR and ARP members, the Foundation is the largest private funding source for rheumatology research and training programs in the U.S. In all, the…

Last Call for 2019 RheumPAC Contributions

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The ACR thanks all members who donated to RheumPAC this year. These contributions enable the ACR to educate key legislators and their staffs about the important issues rheumatologists and rheumatology professionals face. Every dollar raised goes directly to the re-election campaigns of legislative leaders in our field to help those who best understand our issues…

2019 MIPS Reporting via RISE: Are You Ready?

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It’s time to prepare for 2019 MIPS reporting via the Rheumatology Informatics System for Effectiveness (RISE) registry, and the ACR is here to help. To ensure you’re ready to submit your data to the Centers for Medicare & Medicaid Services (CMS), RISE users should take the following steps: Review your data in the dashboard; Make…

Reimbursement Options for Services Without Direct Patient Contact

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Beginning in October 2019, two major commercial payers, UnitedHealthcare and Cigna, discontinued payment for consultation services. The CPT codes affected include 99241–99245 and 99251–99255. The payers have instructed providers to instead bill the non-consultative evaluation and management (E/M) codes that best describe the services performed. If the non-face-to-face service goes beyond the usual time a…

Coding Corner Answers: Navigating Medicare’s Online Resources

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Take the challenge. 1. A—Internet-only manuals Before appealing the request for an overpayment or appealing a denial, providers and staff should first verify the claim was coded and billed correctly. Second, staff should review the internet-only manuals website, which includes operating instructions, policies and procedures that cover CMS policies based on statutes, regulations, guidelines, models…

Coding Corner Questions: Navigating Medicare’s Online Resources

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A practice receives an overpayment request from the Centers for Medicare & Medicaid Services (CMS) for not meeting medical necessity related to a biologic infusion. In which instructional guideline can the coding and billing staff find the necessary information on the CMS website to handle this request? Internet-only manuals National Correct Coding Initiative Medically Unlikely…

How to Navigate & Manage Insurance Overpayments

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Insurance overpayments can occur in a practice for a variety of reasons. An insurer may simply make a mistake by paying a provider more than the contracted amount for a service or pay for a service that is not covered under the patient’s insurance plan. Whatever the reason, overpayments can and will create headaches for…

Leading Boldly: Transforming Rheumatology Campaign Makes Progress

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In 2018, the Rheumatology Research Foundation embarked on its third and most ambitious fundraising campaign, Leading Boldly: Transforming Rheumatology, with a goal of raising $75 million over five years. The campaign supports Foundation programs to recruit the best and brightest into the field, train rheumatology professionals at all career stages and support investigators conducting research…