My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…
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…
Running a rheumatology practice can be expensive. Here are some tips to save money on expenses, while still investing in the growth of your practice and avoiding penny pinching…
The ACR is taking steps to clarify a proposed rule from the Centers for Medicare and Medicaid Services (CMS) that, as currently written, would consider the cost of Part B drugs when calculating physician reimbursement under the Merit-Based Incentive Payment System (MIPS). “The ACR is concerned about this, because large cuts to reimbursement for pass-through…
The final stage of reporting for the Merit-Based Incentive Payment System (MIPS) began Oct. 2, 2017, if you chose the option to report for 90 consecutive days. The MIPS transition year began Jan. 1, 2017, and runs until Dec. 31, 2017. If you subscribed to the Centers for Medicare & Medicaid Services’ (CMS) email, you…
Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…
An established, 66-year-old male patient is seen in the office for a follow-up visit for his fibromyalgia. The physician makes the decision to prescribe venlafaxine for anxiety and depression, and gabapentin for nerve pain. After the visit, the physician informs his medical assistant (MA) to contact the patient’s insurance carrier because venlafaxine requires a prior…
In a world where some information is good, more information is better and information overload is a way of life, Carole Dodge, BS, OTR, CHT—a practicing occupational therapist at the University of Michigan—considers the ARHP her professional block and tackle. “ARHP helps me sift through a lot of information and get it to a digestible…
Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…
The Rheumatology Research Foundation and the ACR are committed to advancing the future of rheumatology to support patients living with rheumatic diseases. These organizations are focused on addressing one of the most critical issues facing patients and rheumatology today—the growing shortage of rheumatology professionals. The ACR’s 2015 Workforce Study revealed the dire need for support…