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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?…

Administrators & Payers Have Hijacked Our Medical Records

Timothy Harrington, MD  |  

I attended medical school in the 1960s, when Dr. Lawrence Weed reinvented the medical record to organize and leverage the physician’s patient evaluation for clarity and quality of care—what he dubbed “the problem-oriented medical record.”1,2 My internal medicine house officer training at Massachusetts General placed a high value on efficient, effective medical records and communication…

Rheumatology’s Challenges Spawn Opportunity

David Daikh, MD, PhD  |  

In our fast-paced world, a great deal can happen in 12 months. Reflecting on this past year and my service as ACR president, I find this has certainly been the case. For the foreseeable future, it appears the factors that influence our ability to effectively care for our patients with rheumatic and musculoskeletal disease will…

The First Step: Pay Equity in Medicine

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“Men work harder than women.” My mother is a pediatrician, and I have two sisters—one is a dermatologist, and one is a real estate attorney. Therefore, I think understandably, this message took me by surprise. Of late, I have been particularly awed by my lawyer-sister, with whom I catch up when she is taking the…