The healthcare industry is currently in an era of higher copays and deductibles, and effective patient collections are critical to the financial health of practices. The front desk staff of a practice is the first area to help with patient satisfaction and the key to a healthy revenue cycle. This front desk staff must collect…
Fellows’ Forum: 7 Tips to Successfully Manage Upward During Fellowship
During the two or three short years of a rheumatology fellowship, there is so much to learn: the subtle art of the musculoskeletal examination, the intricacies of the immune system and the indications for a dizzyingly increasing array of new medications, to name just a few topics. One topic that you rarely hear about, but…
Unwise Choices: EHRs, PBMs, Drug Costs Are Leading to Physician Burnout
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…
Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2
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…
Rheumatology Coding Corner Question: Prolonged Service without Direct Patient Contact, Part 2
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…
Ethics Forum: A Physician’s Medical Error & the Patient’s Right to Know
Case Ms. A is an 82-year-old woman who presented to the rheumatology office for evaluation of osteoporosis. She had been diagnosed with postmenopausal osteoporosis at age 62 after sustaining a right wrist fracture. She was started on alendronate 70 mg weekly and reported medication compliance. At age 79, she sustained an atraumatic right femur fracture….
The ACR, Rheumatology Research Foundation Partner to Expand Rheumatology Workforce
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…
When Is a Doctor Too Old to Practice?
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…
How to Ask for a Raise
Whether you’re a rheumatologist or a rheumatology health professional, unless you are self-employed, the time will come when you start thinking it may be time to ask for a raise. The thought of asking for a raise likely conjures up anything but warm and fuzzy feelings, but if you do it at the right time—and…
Refocus Your Practice with Invigorating Sessions at 2017 ACR/ARHP Annual Meeting
The landscape of practice management and coding methodologies continues to be challenging in the current healthcare environment, and rheumatology practices must maintain focus on managing an effective and efficient practice. Join us at the 2017 ACR/ARHP Annual Meeting, Nov. 3–8 in San Diego, and gain knowledge and understanding of best practices in an ever-changing environment…
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