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

Insurance

Payer Advocacy: The CORC/ISC Is Working for Your Practice

Douglas White, MD  |  

One of the least recognized, most important (certainly for rheumatologists in the U.S. running their own practice), and hardest working committees at the ACR is the Insurance Subcommittee (ISC). Currently chaired by Sean Fahey, MD, and managed by ACR staff liaison Meredith Strozier, this group of dedicated volunteers monitors the insurance landscape, fields complaints from…

Prepare Now to Sell Your Medical Practice

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Selling a medical practice can be a lucrative endeavor. One of the most important phases of any sale transaction is the due diligence process. During this phase, a potential buyer and their advisors have the opportunity to examine the seller’s books, records and files in great detail to ensure that the buyer is comfortable purchasing…

Succession Planning Tips for Rheumatology Practices

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Physicians are no more likely than other people to want to think about what happens next. The question of who takes over for a doctor due to death, disability or retirement has legal, medical and personal implications and requires planning to ensure the succession goes smoothly. “Succession planning is like an advance directive for the…

Insurance Subcommittee Responds to Health Plan Complaints

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The ACR Insurance Subcommittee (ISC) regularly engages with insurance companies to discuss concerns raised by ACR members and advocate for appropriate coverage and payment policies. The ISC has gotten off to a busy start in 2017, working on a variety of patient access and reimbursement issues. Two recent issues the ISC has taken action on…

Undercoding Is Not an Audit-Proof Strategy in Medical Documentation

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Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…

Rheumatology Research Abstracts Highlight Treatment for Hand OA, Risk of Depression in Lupus and More

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WASHINGTON, D.C.—What do treating hand osteoarthritis (OA) in the primary care setting, high financial strain and risk of depression in patients with lupus, prolonged sitting and cardiovascular disease, and sex-specific treatment after total hip arthroplasty have in common? They were all topics presented during a session titled ARHP I: Exemplary Abstracts at the 2016 ACR/ARHP…

The ACR Insurance Subcommittee Advocates for Fair Payer Policies

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The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…

Opinion: Insurance Companies Use Medically and Fiscally Irresponsible Formularies

Bruce Rothschild, MD  |  

Receipt of an unsolicited communication that a sweepstakes award has been won may con some people (especially, but not limited to, those underprivileged or undereducated as to legalities), but can’t fool all of the people all of the time. The names of the organizations and products involved are often marketing tool inventions, which imply special…