Coding medical procedures and diagnoses can be a daunting task if you are not educated in this field. I am going to break down the rules for evaluation and management (E/M) coding, so take a deep breath and let’s jump in!
Make Discoveries at State-of-the-Art Clinical Symposium
Clinical excellence is the foundation of a successful practice. Advancing the integration of evidence-based science and clinical expertise, the State-of-the-Art Clinical Symposium leads the way for rheumatologists to enhance their professional effectiveness and improve their patients’ outcomes.
Advocate from Your Office the Week of March 14
The ACR is urging the 112th Congress to address many issues important to rheumatology including appropriate reimbursement for specialty care, the repeated battle to avert Medicare payment cuts, funding for the pediatric subspecialty loan repayment program, continued fair reimbursement for dual-energy X-ray absorptiometry scans, and the need for increased research funding.
The REF: A Facilitator of Mentoring
The ACR Research and Education Foundation (REF) has made a substantial commitment to supporting career development through its many grant programs, such as the preceptorships for medical and graduate students and residents, the Rheumatology Scientist Development Award, the Rheumatology Investigator Award, and the Career Development Bridge Funding Award, provided in collaboration with the Arthritis Foundation.
2011 CMS e-Prescribing Program: Will You Get Hit with Penalties?
The Medicare Improvements for Patients and Providers Act of 2008 provides for e-prescribing financial incentives in 2011 and financial penalties in 2012 and 2013. When you successfully e-prescribe and report on 25 patient encounters, you will be eligible to receive a 1% incentive of the total estimated allowed charges for professional services covered by Medicare Part B rendered in 2011. The big news, however, is the payment reductions for those who do not successfully meet e-prescribing reporting requirements that will be applied—1% in 2012 and 1.5% in 2013.
RHEUMATOLOGY PRACTICE PEARLS: Is Your Practice Ready for 5010?
If your practice electronically submits administrative transactions to verify patient insurance eligibility, file claims, or send or receive remittance either directly to insurance companies or through a clearinghouse, the transaction version for that system will have to be updated by January 1, 2012. The current version 4010 is outdated and cannot accommodate the necessary business transactions for physician practices and healthcare facilities.
PRACTICE PAGE: The ACR Takes on Insurance Companies
In response to the increasing demands of medical necessity and denials for approved drugs, the ACR is taking a large step towards protecting the rights of members when dealing with insurance companies.
ACR Volunteers Meet in Atlanta for Leadership Development
Volunteers from the ACR, ARHP, and REF met in Atlanta last month for the annual Leadership Development Conference. This year’s keynote lecture was on the changes in healthcare, including quality improvement and emerging reimbursement models such as Accountable Care Organizations (ACOs) and the Pay-for-Performance movement. The topic proved to be very important to the group,…
Shape the Future of ARHP
Volunteering can increase perceived self-efficacy, self-esteem, and positive affect, which all can result in enhanced psychological health. Volunteering leads to the opportunity for social interaction or networking many times with individuals with whom you normally would not interact. A 2009 article found that 20% of the volunteers in their study stated that their health had improved since volunteering and that nearly 30% stated that their lives in general were improved in relation to their volunteering. The association between volunteering and greater health and happiness is a definite plus to volunteering in a professional organization such as the ARHP.
Avoid Coding & Billing Nightmares
Imagine getting a demand letter from a carrier that states your practice has incorrectly billed a procedure for the last year. To make matters worse, the carrier is asking you to return an overpayment, which amounts to thousands of dollars, and they want the full overpayment check within 45 days. Believe it or not, this scenario happens to rheumatology practices across the country.
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