Rheumatology Practice Managers Are Essential for Future Success

Dr. O’Dell

Benjamin Smith

Current ACR membership data reveal that approximately 74% of ACR fellow members work in settings traditionally associated with private practice (solo practice, single and multispecialty group practice, and partnerships). ACR members in academic settings also have clinic responsibilities. As rheumatology practice becomes more complicated with regard to reimbursement, increased costs, staffing, and regulations, having a practice manager is essential to success. Practice managers oversee all business activities including budget monitoring, account receivables/payables, banking, insurance, medication and medical supply purchasing, regulatory compliance, facilities, computers, human resources, staffing, training, office staff supervision, vendor negotiations, and patient relations. They work with the physician—and other medical staff—regarding scheduling, insurance issues, work documentation compliance, and new administrative implementation (e.g., electronic prescriptions or electronic health records). As you can see, a successful practice manager must have organizational, communication, and social skills to work in the position, as well as the ability to multitask and handle crisis management.

The ACR recognizes the importance of practice managers to rheumatology and is providing the resources to ensure their success. In 2013, the ACR/ARHP will introduce a practice-manager membership category. The new category recognizes the importance of practice managers to the rheumatology team and our commitment to providing the best resources for their success. Additionally, in February 2012, the ACR Board of Directors approved the creation of the Practice Managers Task Force. To date, the task force, composed of eight practice managers and ARHP President Benjamin J. Smith, has reviewed the current ACR/ARHP practice manager offerings. The task force will present to the ACR Board of Directors their recommendations for promotion to the practice manager membership. The ACR’s current practice management offerings include a number of opportunities, such as:

• The Business Side of Rheumatology: This is a practical business manual for rheumatologists, fellows-in-training, and practice managers on starting, selling, or redesigning a rheumatology practice.
• Rheumatology Coding Manual: This reference is a guide for rheumatologists, practice managers, and other key staff to help them communicate effectively with third-party payers regarding the medical services provided to patients.
• RheumWATCH: This is a monthly publication about practice management, legislative and regulatory issues, and the ACR’s efforts in Washington.
• Webcasts: A series of free webcasts on areas such as patient documentation, coding, Medicare, health information technology, insurance, legal, and compliance information is available.
• Certified Rheumatology Coder Review Course (CRCR) and Exam: The CRCR exam is designed to provide learning and thoroughly test the coding knowledge of professionals in rheumatology, including physicians, coders/billers, office managers, administrators, consultants, and other health professionals. The ACR’s certified medical coding instructors are available to conduct an intense two-day review course and exam nationwide.
• Coding and Audit Presentations (including ICD-10): The ACR’s coding/reimbursement specialist is available to present coding and self-audit educational sessions at affiliated state society meetings across the United States.
• Chart Auditing: The ACR’s certified healthcare auditor will review a sampling of practice charts and provide a summary of the findings to you and your staff. The summary will include an overview of the coding and documentation rules required for all medical charts.
• Insurance Letters: The ACR provides letter templates online to address the ACR’s position on proper reimbursement practices. ACR members can access these letter templates to generate responses to insurance carriers. Additionally, the ACR sends letters on behalf of members to insurance companies.
• Health Plan Complaint Form: In an effort to better assist in addressing both individual and system-wide insurance issues, the ACR developed a standardized complaint form that can be completed and submitted to the ACR for assistance.
• Benchmarking Resources: The ACR has conducted comprehensive studies to determine benchmarks for rheumatology practices. The most recent economic study was conducted in 2009, and the results are available online. We are working on a new online benchmark to obtain up-to-date information.
• Coding List Serve: This e-mail forum was designed for interactive discussions with your colleagues. The list serve aims to improve communication among members, offer a forum for exchanging ideas, and allow you to benefit from the experience, knowledge, and wisdom of your colleagues.
• Education: A variety of practice-management sessions offered at the ACR/ARHP Annual Meeting (identified in the Business/Administration track) and this year’s practice-management premeeting course on November 10 will include must-attend sessions on areas of revenue cycle management, marketing, contract negotiations, and office management.
• Online Education: The ARHP Fundamentals of Rheumatology Course, which will launch in October 2012, will provide prior authorization education and other modules for health professionals and office staff new to rheumatology. In addition, SessionSelect offers dozens of practice-management topics online ranging from electronic medical records, coding, and audits to revenue streams, building a stronger practice, and ancillary services—all from previous ACR/ARHP meetings.

The ACR knows that to advance rheumatology, the rheumatology team will need to be a multidisciplinary health professional group, with the practice manager as an essential part. As we seek to optimally adapt to the rapidly changing healthcare environment, we are happy to have practice managers on our team and look forward to continuing to help them nurture their career growth.