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

Impact of Medicare Billing Changes Varies by Specialty

Will Boggs, MD  |  

NEW YORK (Reuters Health)—The proposed collapsing of payment amounts for levels 2 to 5 evaluation and management (E/M) services by the U.S. Centers for Medicare and Medicaid Services (CMS) would have different financial impacts on different specialties, researchers report. “Specialists that tend to have more complicated and/or longer visits would lose money, and specialists that…

Beth Jonas: Making a Difference in Training & Workforce Support

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Early in her medical school career, Beth Jonas, MD, FACR, was fascinated by the multi-system and chronic nature of rheumatic diseases. The field of rheumatology offered her the chance to make long-term connections with the patients she cares for, and she says her early instincts have led her to a career that has not disappointed….

Protect Your Practice: Action Update From the ACR’s Insurance Subcommittee

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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…

How to Engage Young Adult Patients

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Gaps in healthcare are common between the ages of 17 and 21. But simple collaborations between adult and pediatric rheumatologists can go a long way to help young adults stay engaged in their rheumatology care…

UnitedHealthcare Retires Fax Numbers Used for Prior Authorization Requests

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Unfortunately, prior authorization continues to be a burden for providers, practices, and patients. Effective Jan. 1, 2019, UnitedHealthcare (UHC) will retire fax numbers used for medical prior authorization (PA) requests. After this date, UHC will require PA requests to be submitted through their Prior Authorization and Notification tool. Providers who can’t submit requests electronically may…

8 Ways to Help Your Patients with Medication Costs

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A patient with rheumatoid arthritis (RA) comes to your office and needs a medication. You prescribe it, and the patient’s insurance plan covers it. The patient begins the medication and slowly but surely feels better. Prescribing drugs for a patient should be this simple but rarely is, thanks to the high cost of drugs and…

Improve Your Claim Submissions Process

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Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as…

Coding Corner Answer: Rheumatology Coding & Practice Quiz

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Take the challenge. B or D—If it was not documented, it was not done is the motto of many coders. For those who follow this motto, the answer would be B. But there is another option for the coder and that is to query the physician about whether the injection was done with ultrasound guidance…

Coding Corner Question: Rheumatology Coding & Practice Quiz

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1. A 45-year-old female patient with a diagnosis of primary osteoarthritis returns to the office for her second scheduled injection of sodium hyaluronate (Supartz). The nurse takes the patient’s vitals: weight is 185 lbs., height is 5’2”, and temperature is 98.2°F. The patient is prepped and given the injection. How should this encounter be coded?…