Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
The ACR has partnered with the American Medical Association (AMA) and over a dozen stakeholder groups to create a set of 21 principles to reform prior authorization protocols. This coalition represents hospitals, medical groups, patients, pharmacists and physicians with a unified goal of creating a more patient-centered, streamlined and transparent process for prior authorization. According…
Coding properly and efficiently can have a profound effect on practice viability. ICD-10’s many changes, both ongoing and planned, have many physicians, coders and practice administrators confused, especially as the changes relate to clinical documentation improvement. To address this issue, a pre-symposium course on documentation and coding will be held in conjunction with the ACR’s…
After 39 years in rheumatology practice, Herbert Baraf, MD, says, “Management has a great influence over the quality of practice.” Here are some tips for physician management…
(Reuters Health)—An examination of more than 100 of the largest U.S. nonprofit organizations created to improve health and fight disease has found that more than 8 in 10 get financial support from companies involved in the drug, biotechnology and medical device industry. In addition, over a third have at least one industry official on their…
The ACR continues to broaden its advocacy efforts on issues critical to rheumatology, as described in updates to its 2017 health policy statements. Along with continuing to advocate for access to care and treatments, enhancements to rheumatology research and training the next generation of rheumatologists, the 2017 health policy statements address a number of new…
As the 115th Congress and the Trump administration consider potential reforms to the healthcare system, including actions related to the Affordable Care Act (ACA), physicians around the country remain vitally concerned about the need to preserve and improve access to care for their patients. To that end, the ACR continues to lobby for policies that…
With all the changing laws and forms to complete, rheumatologists must plan ahead to complete taxes for themselves and their practices. Here are a few insights into what’s changed for your 2016 tax return …
With the termination of the Sustainable Growth Rate formula through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), clinicians who participate in Medicare Part B will now be reimbursed through a new payment model called the Quality Payment Program (QPP). How It Works The QPP rewards the delivery of high-quality patient care via…
Implementation of the Medicare Access and Chip Reauthorization Act of 2015 (MACRA) began Jan. 1. What does this mean for rheumatologists? It means you must pick the measures by which you will be evaluated and the pace at which you will begin reporting in the Merit-Based Incentive Payment System or participating in an Advanced Alternative…