Focus Rheums| Dr. Jekyll or Mr. Hyde? (video)

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Practice Support

Subcategories:Billing/CodingEMRsFacilityInsuranceQuality Assurance/ImprovementTechnologyWorkforce

A Day in the Life of Michael J. Maricic, MD

Eric Butterman  |  

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.

State and Local Society Coding Presentations

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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.

Prior Authorization Struggle Continues

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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

Karen L. Kerr, MSN, NP, CPNP, APRN-BC  |  

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

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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.