Physician Quality Reporting Initiative offers bonuses for clinicians and health professionals
A Day in the Life of Michael J. Maricic, MD
For Michael J. Maricic, MD, the heat is always on—and not just from the scalding temperatures of the ever-present Tucson sun. Strolling through the lobby of his bone clinic, the same sign awaits him every morning: “Our mission is to provide state-of-the-art diagnosis and therapy of rheumatic disorders, combined with compassionate care.” Compassion is a primary adjective in that sentence and in his mind, and Dr. Maricic hopes this commitment will make him and his partners a top practice in a very busy market. After all, Arizona is a place where people retire—often taking their rheumatism with them.
Coding Corner Question
May’s Coding Challenge
Coding Corner Answer
May’s Coding Answer
State and Local Society Coding Presentations
The ACR Practice Advocacy Department will give programs to assist physicians with coding and reimbursement again this year. Last year, ACR coders spoke at more than 15 state and local societies.
Join an ACR/ARHP List Serve Community
Have you ever wanted peer input on a rheumatology-related problem? Thanks to the ACR and ARHP list serves, help is only an e-mail away. The list serves give you unlimited access to rheumatologists or health professional experts. The ACR offers list serves on coding and practice management, advocacy, and five for specific U.S. regions, while the ARHP offers clinical, pediatric, rehabilitation, and research lists. Members can join as many lists as they like.
Since their launch, these list serves have helped ACR members share information and advice on reimbursement challenges and successes, practice tools, research methods, physical therapists in a pediatric hospital setting, and many more topics.
You can choose to receive list updates as they are posted or as one digest message at the end of the day.
For questions on joining, changing your settings, or posting messages, contact Regina Adair at (404) 633-3777, ext. 817 or [email protected] (for ACR lists), or Julie Anderson at ext. 802 or [email protected] (for ARHP lists).
Prior Authorization Struggle Continues
Many Medicare Part D plans continue to request prior authorizations for several drugs commonly prescribed by rheumatologists. The ACR has been working diligently with Robert Bennett of the Physician Regulatory Issues Team (PRIT) to avoid the same problems many physicians had last year. PRIT advises all physicians to write “for Part D” along with the diagnosis on the prescription, to verify that the drugs are for Part D diagnoses and should not be paid under Part B. This way the administrators of the prescription drug plans (PDPs) can waive the need for a new prior authorization—saving time and money for physicians, pharmacists, and the PDPs.
The Quest for Quality
The ARHP has an important role to play as the ACR addresses the emerging quality movement in healthcare. Most healthcare professionals are familiar with terms such as quality assurance, continuous quality improvement, and total quality management. In the late 1980s, healthcare organizations, following the lead of the manufacturing industry, began to implement quality-management programs as a way to improve the quality and cost efficiency of healthcare services and meet rising consumer expectations.
Maximize Reimbursement by Managing Denials
Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.
On Board with Baby
Rheumatology programs make strides in work–life balance support
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