ATLANTA—The rheumatology profession faces a severe shortfall of practitioners that threatens the ability to address patients’ needs. “Even if we doubled the number of positions for fellowship training, we wouldn’t meet the increasing demand on our workforce,” said Marcy B. Bolster, MD, associate professor of medicine at Harvard Medical School, Boston, and director of the…
As the medications for rheumatology become more expensive, the need for patient financial assistance becomes paramount. Unfortunately, commercially insured patients are finding it difficult to afford the exorbitant copays required by their plans, and the latest strategy of pharmacy benefit managers (PBMs) threatens to derail rheumatologic treatment goals. High deductible plans combined with copay accumulator…
The ACR Insurance Subcommittee is working to address specialty pharmacy requirements for in-office treatments, elimination of consultation codes and other coverage and reimbursement challenges.
When insurance company practices put patients at risk, advocacy is an important tool physicians can use to make a real difference. You can make a difference.
Sales and marketing representatives can add tremendous value to your practice: They can generate consistent business by leveraging contacts who have services that can be referred to your practice. However, the services a sales and marketing representative provides are subject to significant scrutiny under the federal Anti-Kickback Statute and state equivalents. For this reason, the…
ATLANTA—Obtaining prior authorization to ensure services or prescription drugs are covered by a patient’s health plan consumes staff time, and delays or denials may cause patients to abandon treatment, according to speakers at the 2019 ACR/ARP Annual Meeting. In a session on Nov. 10, the experts shared tips to smooth the process. Train Staff on…
ATLANTA—With growing demand for access to rheumatologists in rural areas, a shortage in the number of rheumatologists and the ability to use technology as a bridge to patients in remote areas, telemedicine seems like a smart option. And it certainly can be, experts said at a 2019 ACR/ARP Annual Meeting session in November. But a…
Predictive data models can be used to identify when patients may miss their appointments, reduce these incidents and increase scheduling efficiency. Here are some tips for the physician practice setting…
Based on a request by the ACR Insurance Subcommittee, off-label use of mycophenolate for scleroderma has been added to a Medicare-approved compendium.
The Rheumatology Informatics System for Effectiveness (RISE) 2019 MIPS submission tool will open in mid-January. RISE staff are in the process of completing final data refreshes and reviews to ensure data accuracy. The ACR will notify all practices as soon as the submission tool is open. Practices are requested to complete their submission by March…