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The AHIMA survey reports that employers “agree” to “strongly agree” that credentialed employees help reduce exposure to fraud and abuse (70%), improve the delivery of quality healthcare (68%), and require less training (68%).

A certified rheumatology coder knows the correct application for CPT and ICD-9 diagnosis for rheumatologic services. This means they are more able to translate diagnostic and procedural phrases into numerical codes used for billing and reimbursement purposes by insurance companies, safeguarding your practice against unnecessary audits.

The U.S. Department of Health & Human Services recently reported that the Medicare Fraud Strike Force operations in nine locations have charged more than 1,140 defendants who collectively have falsely billed the Medicare program for more than $2.9 billion since 2007. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS Office of Inspector General, are taking steps to increase accountability and decrease the presence of fraudulent providers.

“Physicians are encouraged to hire certified coders in their facility to safeguard against errors or fraud,” states Antanya Chung, CPC, CPC-I, CRHC, CCP, ACR director practice management. She continues, “Certification shows qualification and with the current result of recoupments for incorrect billing of codes, rheumatologists cannot take the chance of hiring coders or billers that are not certified.”

The ACR places a concentrated focus on the importance of continuing education and certification on coding as a critical element in effective healthcare management in rheumatology practice. The ACR has two certified professional coders on staff to help members answer questions related to rheumatology coding and billing. ACR coders are also available to give coding and compliance presentations in your state. For more information and to schedule a presentation, contact the coding department at [email protected].

Additionally, the ACR has ICD-10 transition tools to help you implement the new code set, which goes into effect October 1, 2013. Visit www.rheumatology.org/practice for more information.

Reference

1. American Health Information Management Association. Employers Value Credentials in Healthcare. 2005. Available at www.ahima.org/downloads/pdfs/certification/Employee Valuesurvey.pdf. Accessed September 21, 2011.