Take the challenge. B—No. Although the documentation states the patient arrived at the clinic at 8:15 a.m. and left the clinic at 10:55 a.m., it does not document the actual start and stop times of the infusion. According to CPT, when reporting codes for which infusion time is a factor, use the actual time over…
Preparing for Increased HIPAA Audits Among Smaller Rheumatology Providers
Recent enforcement activities of the Department of Health and Human Services’ Office for Civil Rights (OCR) have shown an increase in fines and penalties assessed against smaller providers for failing to comply with the privacy, security and breach notification requirements of the Health Insurance Portability and Accountability Act (HIPAA). Historically, OCR has focused on larger…
Role of Dietitians in Rheumatology
What do dietitians do to help manage patients with rheumatic disease? Dietitians are well integrated, for example, in the practice of nephrology and diabetes, but few are active in the specialty of rheumatology. However, dietitians are recognized as part of the team of providers designated to care for patients with rheumatic disease by the ACR….
Opinion: Adhering to Standards of Care Helps Manage Risk
Medicare and other third-party payers have started predicating reimbursement on adherence to standards of care. Post hoc chart reviews have resulted in substantial take-backs for failure to adhere to those values in cardiology, pulmonology and expanding to other areas. Outpatient medicine is also being subjected to such scrutiny. The question of standards and who sets…
Phase 2 of HIPAA Audit Program Launches
With many competing priorities facing physician practices, HIPAA compliance and security is not a topic that usually makes it to the top of the list. But this is not the case with the Department of Health and Human Services’ Office for Civil Rights (OCR), because it has initiated a new phase of audits of physician…
Implementing Successful Care Management Programs for High-Cost Patients
As healthcare delivery increasingly moves from volume-based care to value-based care, providers are needing to adopt new practices to meet what is now commonly referred to as the triple aim of healthcare delivery—improving the patient experience of care (which includes satisfaction and quality), improving the health of populations and reducing cost.1 Among the most difficult…
Addressing the Rheumatology Workforce Shortage
In 2008, the American College of Rheumatology Workforce Study Advisory Group published a comprehensive rheumatology workforce analysis.1 It concluded: Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include…
Tips for Increasing Your Client Base
Recruiting new patients requires a multi-faceted approach. A rheumatologist must have a solid brand and marketing platform, as well as an active strategy to attract and convert new patients. This might involve embracing social media, having a website, developing a referral network, being involved in your community and nurturing existing patients. Your brand includes such…
Why Physicians Say Sick Days Aren’t Worth the Trouble
A recent JAMA Pediatrics article found that 83% of clinicians admitted to coming to work while sick and 95% admitted to knowing that it could be dangerous for their patients.1 “The decision to work sick is shaped by systems-level and sociocultural factors,” the study authors wrote. In speaking with rheumatologists on the matter, I found…
Tips for Setting Treatment Goals with the Patient
When working with a newly diagnosed patient to determine a treatment plan, ensure the patient has a good understanding of the diagnosis, the options available and what the options entail. “It is important to help patients understand that there are choices, and that their decisions should be based on what matters to them,” says Susan…
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