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ACR Makes Strides in Practice Management Education
An important aspect of managing an effective, efficient rheumatology practice is staying abreast of new and evolving practice management trends. The healthcare environment will continue to experience constant change. Payment models, audits, ICD-10, and measuring performance are only a few of the many areas requiring focus, research, and implementation strategies from an administration perspective. More important, we must examine the costs associated with implementing these changes and the impact they have on liability and revenue to the practice. Physicians, administrators, and staff must embrace the challenges and broaden their knowledge to thrive in a healthcare environment that is transforming before our eyes.
The ACR Committee on Rheumatologic Care (CORC) has researched industry trends and is offering a variety of stimulating courses to help you to stay up to date with these changes. These learning opportunities include a premeeting practice management course, premeeting rheumatology coding course, and more in-depth practice sessions scheduled throughout the ACR/ARHP Annual Meeting to be held in San Diego October 25–30.
“It’s not enough for rheumatologists and administrators to focus solely on medical issues,” says Douglas White, MD, CORC liaison to the ACR Annual Meeting Planning Committee. “With the spotlight on cost containment and more effective delivery of services, rheumatologists need to understand all that is happening today and how it will affect their practice tomorrow.” Dr. White states that the ACR practice management sessions will help physicians understand how to better manage their practices in a way that complies with developing requirements.
In May 2012, the Department of Health and Human Services Office of Inspector General (OIG) released a report titled, “Coding Trends of Evaluation and Management Services,” in an effort to make the healthcare community aware of the cost increase to render these services.¹ The report indicated that evaluation and management payments from Medicare increased 48% between 2001 and 2010, while other Part B service payments increased only 43%. The OIG forwarded their findings to the Centers for Medicare and Medicaid Services (CMS) with a recommendation to increase educational outreach to physicians on specific areas such as policies, rules, and regulations. As another key portion of the report states, “Physicians must ensure that their information is responsibly reported by other parties, as well as learn to use data themselves for improving their practices and remaining relevant in the changing healthcare marketplace. It is critical that physicians begin to review and understand their claims and other data to: 1) reduce healthcare costs by eliminating the currently inexplicable variation in treatment patterns; 2) ensure that their publicly reported practice profiles are accurate; 3) improve the quality and efficiency of their practices; and 4) prepare themselves for the new budget-based payment models that depend on the variation between projected and actual use, and cost of resources, rather than on maximizing volume of services.”1
The ACR emphasizes the importance of continuing education in practice management and coding as critical elements in effective healthcare management in rheumatology practices. The one-day premeeting practice management course is designed for physicians and administrators to thrive in the new era of healthcare. The sessions cover key areas that physicians, administrators, and practice managers must embrace to evolve their rheumatology practices in the 21st-century healthcare environment. The course will feature top consultants in the field of practice management and cover topics like lean-measuring culture to improvement performance, mastering the revenue cycle, human resources management, new HIPAA guidelines, and preventing fraud and embezzlement. CORC’s goal is to provide rheumatology practices with tools and resources that may be implemented immediately after administrators return to the office and positively impact practices right away.
Coders are instrumental in keeping physician practices compliant by coding documentation accurately, properly reviewing medical records, and staying up to date with code changes. The coding review course is designed to provide coders, medical billing staff, and physicians with an in-depth understanding of coding and billing regulations. The presenters, Antanya Chung, CPC, CPC-I, and Melesia Tillman, CHA, CPC, CPC-I, have more than 15 years of combined experience in coding and are experts in the field. The course will cover human anatomy, physiology, and medical terminology to ensure correct coding of rheumatology services. Additionally, they will share current issues regarding compliance and reimbursements to help attendees understand coding rules and guidelines. The presenters also will discuss best practices for effective claims billing, insurance follow-up, and the appeals processes. “Our volunteers understand the roadblocks that rheumatologists in practice encounter trying to obtain reimbursement from insurance carriers. Hence, offering a coding course that dives into specific rheumatology coding guidelines,” is highly important, says Dr. White.
In addition to the preconference courses, CORC is also offering an array of practice sessions during the regular annual meeting schedule. We are excited to offer our members a session titled, “Disaster Planning: How to prepare for a catastrophe and minimize your liability” with renowned speaker Emily Friedman. With the increase in natural disasters nationwide, CORC felt it was important to provide members a session on how to prepare for unimaginable events. Other sessions include significant topics like ICD-10 implementation, audits management, risk management, the patient-centered medical home model in rheumatology, and physician profiling.
Network, Learn, Discover
The practice management and coding courses go beyond understanding industry standards. Courses offer attendees the opportunity to network, garner information on business standards and trends, and discuss other complex issues affecting rheumatology practices. Administrators, physicians, and coding and billing staff find these sessions to be solid opportunities to build a support system and share best practices. These professional networks can be beneficial once the meeting is over and everyone returns to the daily routine of managing an effective and efficient rheumatology practice.