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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Prior Authorization Struggle Continues

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Many Medicare Part D plans continue to request prior authorizations for several drugs commonly prescribed by rheumatologists. The ACR has been working diligently with Robert Bennett of the Physician Regulatory Issues Team (PRIT) to avoid the same problems many physicians had last year. PRIT advises all physicians to write “for Part D” along with the diagnosis on the prescription, to verify that the drugs are for Part D diagnoses and should not be paid under Part B. This way the administrators of the prescription drug plans (PDPs) can waive the need for a new prior authorization—saving time and money for physicians, pharmacists, and the PDPs.

The Quest for Quality

Karen L. Kerr, MSN, NP, CPNP, APRN-BC  |  

The ARHP has an important role to play as the ACR addresses the emerging quality movement in healthcare. Most healthcare professionals are familiar with terms such as quality assurance, continuous quality improvement, and total quality management. In the late 1980s, healthcare organizations, following the lead of the manufacturing industry, began to implement quality-management programs as a way to improve the quality and cost efficiency of healthcare services and meet rising consumer expectations.

Maximize Reimbursement by Managing Denials

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Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.

Cost of a Free Lunch

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Much is made of pharma’s influence on CME—but do we really know what this educational funding buys?

Make Our Voice Heard

Neal S. Birnbaum, MD  |  

It’s up to you to take rheumatology’s case to Congress

On Board with Baby

Sheri Polley  |  

Rheumatology programs make strides in work–life balance support