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The ACR Practice Management Department actively works to provide valuable, accessible resources addressing practice issues on a local and national level to rheumatologists and their staff. Our trained professionals are devoted to providing the most up-to-date tools and resources to help improve practice efficiency while meeting the myriad compliance obligations of the ever-changing healthcare landscape.
The practice management resource center is designed to assist with such issues as coding and billing guidelines, office compliance, documentation and denial management, as well as the intricate details of working with Medicare, private insurers and even self-pay patients.
Practices can receive assistance and gain solutions to practice management, coding and billing issues by utilizing the ACR website at https://www.rheumatology.org/Practice-Quality.
Key resources include:
Advanced Rheumatology Coding & CDI Boot Camp
The Advanced Rheumatology Coding and CDI Boot Camp provides physicians, coders, billers and practice managers with in-depth education on new and changing documentation requirements and clinical criteria necessary to appropriately assign codes. The ACR certified coders and CDI specialists will conduct this eight-hour course with an overview of key coding guidelines, physician documentation requirements by body system and understanding of the ICD-10 and procedural coding structure, and discuss changes to the guidelines in ICD-10-CM for frequently reported diagnoses. Participants leave class ready to maximize documentation efforts for diagnoses and E/M and procedural codes commonly targeted by third-party and government payers.
Rheumatology-specific Coding and CDI Boot Camps will be offered nationwide at various locations. For a list of upcoming courses, contact the Practice Management Department at [email protected].
Additional coding and billing resources can be found at https://www.rheumatology.org/Practice-Quality/Administrative-Support/Coding.
E/M Chart Auditing—Avoid Audit Risks
As required by the Tax Relief and Health Care Act of 2006, the CMS has implemented Medicare recovery auditing in all states. This, along with the OIG’s 2017 semiannual report on recovering over $2 billion in overpayment, means the claims auditing movement is now moving forward at full speed. This hands-on training program is designed to assist rheumatology practices recognize the steps essential to identify documentation improvement and coding risk areas before a third-party or government audit. For more information on self-auditing or to schedule an onsite meeting, contact ACR-certified healthcare auditors at [email protected].
In-depth information on CMS auditing and program integrity can be found at https://www.rheumatology.org/Practice-Quality/Administrative-Support/Practice-Resources/Audit-Programs.
Certified Rheumatology Coder Review Course & Exam
The CRHC 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 Practice Management Department will send its PMCC coding instructor to conduct a day-long review course and administer the three-and-a-half hour exam at several different locations throughout the U.S. To review the certification guidelines or register for a course, visit the ACR website at https://www.rheumatology.org/Learning-Center/Educational-Activities/Details?meetingId={C818A218-D658-E611-8F1A-005056987EFD}.
Business Side of Rheumatology
A practical online business manual for rheumatologists, fellows in training and practice administrators on starting, selling or redesigning a rheumatology practice can be downloaded from https://www.rheumatology.org/Practice-Quality/Administrative-Support/Practice-Resources/Practice-Publications.
Rheumatology Coding Manual
This electronic coding reference is a practical guide for rheumatologists and their staff to communicate effectively with third-party payers regarding the medical services provided to patients. The ACR Rheumatology Coding Manual can also be used by practices as a hands-on tool for new clinical and coding staff to familiarize themselves with rheumatology coding. Download this practical guide to effectively code and bill the most common rheumatology services from https://www.rheumatology.org/Practice-Quality/Administrative-Support/Practice-Resources/Practice-Publications.
Insurance Letters
The ACR provides online letter templates addressing the ACR’s position on proper reimbursement practices for rheumatology services. Additionally, the ACR sends letters on behalf of members to insurance companies concerning payment and policy issues affecting rheumatology practices. Online letter templates can be downloaded from the ACR website at https://www.rheumatology.org/Practice-Quality/Administrative-Support/Insurance-Advocacy/Tools-Resources.
Health Plan Complaint Form
In an effort to better assist both individual and system-wide insurance issues, the ACR developed a standardized complaint form, which can be completed and submitted to the ACR for assistance. If you are experiencing a problem with an insurance health plan, download and complete the complaint form at https://www.rheumatology.org/Practice-Quality/Administrative-Support/Insurance-Advocacy.
Education
The Practice Management Department works with the Education Department to provide sessions during the ACR/ARHP Annual Meeting. This year, we’re offering two pre-meeting courses: the Clinical Validation, Documentation & Coding Workshop on Oct. 19 and Putting the Pieces Together: Winning Strategies for Rheumatology Practices on Oct. 20. These sessions will cover coding guidelines for medical necessity, revenue cycle management, marketing, contract negotiations and office management, which are pivotal for ongoing achievement and success in rheumatology practices. Visit the ACR website for the latest registration information at https://www.rheumatology.org/Annual-Meeting.
