Late last month, the Centers for Medicare & Medicaid Services (CMS) released an advance notice of proposed rulemaking (ANPRM), seeking feedback on a potential drug pricing model called the International Pricing Index (IPI) model. This comment solicitation is in alignment with the administration’s blueprint to lower drug costs and reduce out-of-pocket costs, and is an…
UnitedHealthcare Retires Fax Numbers Used for Prior Authorization Requests
Unfortunately, prior authorization continues to be a burden for providers, practices, and patients. Effective Jan. 1, 2019, UnitedHealthcare (UHC) will retire fax numbers used for medical prior authorization (PA) requests. After this date, UHC will require PA requests to be submitted through their Prior Authorization and Notification tool. Providers who can’t submit requests electronically may…
Improve Your Claim Submissions Process
Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as…
Fighting Lupus Among Latinas
Systemic lupus erythematosus (SLE) is more prevalent among Hispanic women than white women, according to two recent studies published in Arthritis & Rheumatology.1,2 However, Latinas often lack awareness of lupus, which can contribute to delays in diagnosis and treatment, and lead to worse outcomes. “One of the challenges is reaching out to the Latino community,…
Coding Corner Answer: Rheumatology Coding & Practice Quiz
Take the challenge. B or D—If it was not documented, it was not done is the motto of many coders. For those who follow this motto, the answer would be B. But there is another option for the coder and that is to query the physician about whether the injection was done with ultrasound guidance…
Coding Corner Question: Rheumatology Coding & Practice Quiz
1. A 45-year-old female patient with a diagnosis of primary osteoarthritis returns to the office for her second scheduled injection of sodium hyaluronate (Supartz). The nurse takes the patient’s vitals: weight is 185 lbs., height is 5’2”, and temperature is 98.2°F. The patient is prepped and given the injection. How should this encounter be coded?…
2018 Annual Meeting Attendees Receive Complimentary ACR Beyond Subscription
The ACR/ARHP is very pleased to announce that all scientific attendees at the 2018 ACR/ARHP Annual Meeting will receive a complimentary one-year subscription to ACR Beyond streaming (a $279 value). This complimentary subscription includes not only all of the recorded sessions from the 2018 ACR/ARHP Annual Meeting, but also more than 500 sessions from past…
A New Endowment Will Support Pediatric Rheumatology Fellowships
The Rheumatology Research Foundation has received a major donation from Audrey M. Nelson, MD, a retired rheumatologist from the Mayo Clinic in Rochester, Minn. The Audrey M. Nelson, MD, Pediatric Rheumatology Fellowship Endowment in Training will support training awards for pediatric rheumatology fellowships. This generous donation addresses the growing demand for pediatric rheumatologists to ensure…
Dr. Hazel L. Breland to Begin Term as ARHP President
Hazel L. Breland, PhD, ORT/L, FAOTA, CLA, assumes the role of ARHP president in October. She is the 50th person to hold that honor, and the organization’s first African-American leader. “Several things came together at one time that I didn’t necessarily think about when I was asked what my aspirations in the organization were in…
ACR Policy: The Mouse That Roared
Do you remember the 1959 movie, The Mouse That Roared? Through a few small actions, the Duchy of Grand Fenwick, a small, often overlooked principality, becomes a superpower on the world map overnight. In many ways, rheumatology has been in the same position. We are a small specialty; we don’t have well-known diseases. Although our…
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