Chatbots are not a new concept, but have recently gained popularity and traction. Launched in late 2022, ChatGPT (Chat Generative Pre-Trained Transformer) is a web-based platform designed to simulate interactive conversations and deliver real-time data. It has quickly become a tool that provides instantaneous information that can be more focused than a Google search.1 We,…
Don’t reinvent the wheel. The ACR Committee on Rheumatologic Care offers members an updated slate of template letters to help appeal insurance denials for common off-label rheumatology treatments.
Three commercial health insurance payers have increased reimbursement for infliximab biosimilars in response to concerns that formulary requirements are leaving practices underwater.
On April 1, UnitedHealthcare updated reimbursement for infliximab biosimilars in response to concerns that formulary requirements are leaving practices underwater.
The Feb. 21 cyberattack on Change Healthcare, the clearinghouse vendor that connects providers with insurance payers, including Medicare, has caused unprecedented challenges and had a critical financial impact on payments to providers nationwide. UnitedHealthcare Group (UHG), the parent company of Change, confirmed on March 8 that it is making significant progress to restore all systems….
The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices, including issues related to biosimilar use, in-office treatments and the new G2211 code.
The ACR is reaching out to Medicare Advantage and commercial payers to ensure appropriate reimbursement for the new complex care add-on code, G2211, implemented for outpatient office visits starting Jan. 1, 2024.
Reimbursement has fallen below acquisition price for some biosimilar versions of infliximab, forcing practices and patients to make difficult decisions. The ACR is working to change this.
After meeting with the ACR and other stakeholders, Blue Cross NC and OMI announced revisions to their Autoimmune Pathways Program to drop biologic tapering requirements and paying providers according to specific treatment decisions.
During a busy start to 2023, the ISC has been advocating with payers to address multiple coverage and reimbursement challenges facing rheumatology practices, including Cigna’s modifier 25 requirements, hydroxychloroquine access and coverage for apremilast combination therapy.