The ACR can be the first line of defense for rheumatologists when it comes to compliance efforts, quality control and oversight of physician billing and coding practices, says ACR Director of Practice Management Antanya Chung, CPC, CPC-I, CRHC, CCP. The ACR is focused on providing the support its members want and need.
“We want to protect not only their bottom line as business owners, but also their livelihood and their passion,” Ms. Chung says. “We are just one gear in the wheel that keeps the machine turning, but we want our members to know that we’re here for them, and we will help in any way that we can.”
How the ACR Helps with Practice Issues
The ACR lends valuable practice assistance to its members via various services and programs, such as:
1. Chart audits: As a free service, the ACR provides chart auditing to review everything from HIPAA compliance, to evaluation/management documentation guidelines, to proper ICD-10 coding. Typically, Ms. Chung says, certified health code auditors on staff will review up to five charts that reflect the variety of services a given rheumatologist member provides, including new patient, established patient and ancillary services. These can be services that have already been billed or are awaiting payment review—or even those that have been denied.
“We review charts completely, against an auditing sheet used nationwide, to make sure they hit the points needed and give the final outcomes of the code,” says Ms. Chung. “After review, we send physicians back a full report, and call or email to go over the results.”
For a small fee, the ACR also offers its members a number of audit and documentation courses to groups of 10 or more. The ACR website includes more information on auditing services.
“The Office of the Inspector General [OIG] indicates physicians should do self-audits at least once a quarter and, at minimum, twice a year,” says Ms. Chung. “Even if you find and report errors, it shows good faith that you are trying to keep up the best you can.”
2. Compliance plans: “We’ve created a mock compliance plan and highlighted some of the key areas physicians need to be aware of to make sure they are up-to-date with the latest compliance requirements,” says Ms. Chung.
At this year’s ACR/ARHP Annual Meeting, the ACR offered sessions that concentrated on compliance, particularly as it applies to HIPAA guidelines. Ms. Chung says that, as a compliance officer, she is available to visit member practices to help outline plans and provide a full review.
“When an auditor comes in, they’re looking at everything. Do you have a compliance plan your employees can refer to?” she says.
3. Billing assistance & education: “One of the biggest things we offer is help making sure our members are billing correctly,” says Ms. Chung. “We achieve this through offering the certified rheumatology coder (CRHC) review course and exam nationwide. The CRHC course is classroom based and available during the ACR/ARHP Annual Meeting, or members can contact the practice staff to set up a course in their area.” Often state societies will request courses to be held in conjunction with their local annual meetings.
A New Service for the New Year
In 2017, the ACR will focus on education around revenue cycle management, from “front end to back end,” says Ms. Chung. “We will work to help practices manage their accounts receivable appropriately and assist with practical solutions for process workflow.”
Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wis.