The ACR Practice Advocacy Department will give programs to assist physicians with coding and reimbursement again this year. Last year, ACR coders spoke at more than 15 state and local societies.
Prior Authorization Struggle Continues
Many Medicare Part D plans continue to request prior authorizations for several drugs commonly prescribed by rheumatologists. The ACR has been working diligently with Robert Bennett of the Physician Regulatory Issues Team (PRIT) to avoid the same problems many physicians had last year. PRIT advises all physicians to write “for Part D” along with the diagnosis on the prescription, to verify that the drugs are for Part D diagnoses and should not be paid under Part B. This way the administrators of the prescription drug plans (PDPs) can waive the need for a new prior authorization—saving time and money for physicians, pharmacists, and the PDPs.
The Quest for Quality
The ARHP has an important role to play as the ACR addresses the emerging quality movement in healthcare. Most healthcare professionals are familiar with terms such as quality assurance, continuous quality improvement, and total quality management. In the late 1980s, healthcare organizations, following the lead of the manufacturing industry, began to implement quality-management programs as a way to improve the quality and cost efficiency of healthcare services and meet rising consumer expectations.
Maximize Reimbursement by Managing Denials
Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.
On Board with Baby
Rheumatology programs make strides in work–life balance support
Readers Answer ‘Twenty Questions’
The March Rheuminations column, “Twenty Questions, Part 1” inspired many letters from TR readers. Here are just a few of those responses.
Coding Corner Answer
March’s Coding Answer
Coding Corner Question
April’s Coding Challenge
Now’s Your Chance to Join an ACR Committee
Volunteers who serve on the ACR’s committees and subcommittees are a vital component of the organization’s ability to respond to the rheumatology landscape for the benefit of members. There are many complex issues facing the subspecialty of rheumatology; it is those dedicated members who choose to become involved who drive the organization’s achievements in advocacy, training, recruitment, education, practice support, and the development of professional standards.
Medicare Switch to ASP Pricing Reduces Part B Spending
The Medicare Payment Advisory Commission (MedPAC) reported to Congress in January that Medicare’s switch to a payment method known as ASP, or Average Sale Price, has reduced spending on drugs in the Medicare Part B program. This system reflects actual market spending, rather than wholesale prices.