Exclusive: ACR Convergence 2024| Focus Rheums

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

Practice Support

Subcategories:Billing/CodingEMRsFacilityInsuranceQuality Assurance/ImprovementTechnologyWorkforce

Clean Claims Equal Prompt Payment

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Submitting a clean Medicare reimbursement claim the first time can save your practice thousands of dollars each year. The Centers for Medicare and Medicaid Services (CMS) defines a clean claim as “a submitted patient claim form without any defect or need for substantiation.”

Is Your Office Lab Up to Par?

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Rheumatology practices with laboratory testing facilities in their offices can offer important benefits to patients and physicians. During their care of patients with musculoskeletal and rheumatic diseases, rheumatologists may order many tests, including erythrocyte sedimentation rate, synovial fluid analysis, complete blood count, fecal occult test, and urinalysis. While the prompt receipt of test results and the capability to evaluate specimens in the office directly improves efficiency, it is important to remember that offices must be certified to perform laboratory testing, particularly high-complexity tests such as the analysis of synovial fluids.

Fraud and Abuse: What’s the Difference?

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Each year, fraud and abuse cost the Medicare and Medicaid programs billions of dollars. What is the difference between fraud and abuse? The Centers for Medicare & Medicaid Services define fraud and abuse as two different offenses…

National HMO Class-Action Case Settled

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The latest development in the healthcare class-action settlement will affect approximately 900,000 physicians (and some major state medical societies) who may be eligible to receive compensation from the settlement – as long as they file a claim. The case has been called “historic” by those representing both physicians and insurance companies.