When the first laboratory-confirmed COVID-19 case was reported by the Centers for Disease Control & Prevention (CDC) on Jan. 22, it was difficult to predict an ensuing global pandemic would last for more than half the year. Approximately one week after the initial CDC report, the U.S. Department of Health & Human Services (HHS) declared…
The new diagnostic code should streamline billing for treatment of nr-axSpA, better define the spectrum of spondyloarthritic diseases and enable new research strategies into these conditions.
As the number of COVID-19 cases continues to rise in the U.S., the fast spread of the virus is causing gaps in practice staffing, and patient influx will likely increase, leaving systems needing more providers. The use of locum tenens physicians can help practice fill gaps at your organization caused by COVID-19. Below we offer…
Humans may fear change as a general rule, but we’re adaptable when we need to be. In this era of COVID-19 and social distancing, medical practices and payers are adapting to an increased use of telemedicine, which enables providers to see their patients without being in a room with them. To cope, the Centers for…
Take the challenge. D. When an infusion is ordered by the provider, there should be a signed order from the provider. If a prior authorization is needed, it should be obtained, with the number of infusions, along with the start and end dates of the authorization. Also, a prior authorization does not guarantee reimbursement; an…
A 65-year-old male patient diagnosed with rheumatoid arthritis at multiple sites without rheumatoid factor has been ordered to have infliximab infusions. What should support staff do to ensure this procedure can be given to the patient? Make sure there is a signed order from the provider Make sure a prior authorization is obtained Make sure…
The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….
The ACR has created a chart of temporary changes to commercial payers’ telehealth policies that make it easier for physicians and patients to connect without the need for an office visit.
ATLANTA—From step therapy requirements to infusion center locations to evaluation and management coding, insurance issues bring frequent headaches to clinicians and patients. Experts discussed some of the most recent concerns in a session at the 2019 ACR/ARP Annual Meeting. Chris Phillips, MD, chair of the ACR’s Insurance Subcommittee (ISC), and Gary Bryant, MD, delegate to…
Timothy Laing, MD, will continue to represent the ACR in his third stint on the AMA’s Relative Value System Update Committee, helping determine the relative value of clinical services.