In partnership with rheumatology and other specialty organizations, the ACR is working against payer and employer policies that mandate specialty pharmacy acquisition of in-office treatments.
Coverage & Reimbursement Challenges: Updates from the ACR Insurance Subcommittee Chair
The ACR Insurance Subcommittee is working to address specialty pharmacy requirements for in-office treatments, elimination of consultation codes and other coverage and reimbursement challenges.
Are Your Patients at Risk? Advocacy Matters
When insurance company practices put patients at risk, advocacy is an important tool physicians can use to make a real difference. You can make a difference.
Off-Label Coverage of Mycophenolate for Scleroderma under Medicare Part D
Based on a request by the ACR Insurance Subcommittee, off-label use of mycophenolate for scleroderma has been added to a Medicare-approved compendium.
How to Navigate & Manage Insurance Overpayments
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…
Tap the ACR/ARP’s Practice Management Resources
The ACR/ARP’s practice management division actively works to offer rheumatologists and their staff valuable, accessible resources to address practice issues. Our trained professionals provide the most up-to-date tools and resources to help improve practice efficiency and meet the myriad compliance obligations of the ever-changing healthcare landscape. The Practice Management Resource Center can assist with such…
Bringing a Frontline Perspective to Insurance Advocacy
Early in his career as a resident at Washington University in St. Louis, Mo., Christopher Phillips, MD, felt a connection to his patients battling rheumatic diseases. Today, Dr. Phillips balances time with his solo private practice in Paducah, Ky., to help rheumatologists fight insurance battles for their patients in his role as chair of the…
Coverage Requirements for HLA-B27 Vary by Testing Methodology
Did you know a laboratory can perform one of two different tests when a provider orders an HLA-B27 blood test? The ACR Insurance Subcommittee has received several complaints regarding commercial payer coverage for these tests, depending on which methodology the lab employs. To avoid administrative burden, members should familiarize themselves with lab practices and payer…
Protect Your Practice: Action Update From the ACR’s Insurance Subcommittee
Both private and academic rheumatology practices face payer challenges that put the health of their patients and their practices at risk. To make sure the rheumatologist perspective is heard by payers, “the ACR’s Insurance Subcommittee (ISC) serves as the interface between payers and our members and ACR colleagues,” explains Sean Fahey, MD, a rheumatologist in…
ACR Insurance Subcommittee Responds to Payer Policies
Since the beginning of the year, the ISC has sent eight letters to payers in response to problematic policies. Each letter outlines the ACR’s concerns and requests corrective action…