Amar Majjhoo, MD, had just completed his rheumatology fellowship in 2005 when he attended his first meeting of the Michigan Rheumatism Society. “I thought it was exciting that we had a state society, because to me, everything was new,” says the Michigan-based, private practice rheumatologist. “Having a meeting where established doctors were sitting around was…
CVS Rolls Out New Tool to Combat Rising Drug Prices
(Reuters)—Drugstore chain CVS Health Corp on Wednesday launched a new tool that will allow pharmacies help customers tackle the soaring cost of drugs by comparing prices of medicines. U.S. healthcare companies, ranging from insurers to drug retailers, are stepping up efforts to combat rising drug prices that has been widely criticized by regulators and has…
Prior Authorizations Hurt Patients & Practices
The ACR was part of a 16-member collaboration that created a set of 21 principles on prior authorization and utilization management, intended to ensure that patients receive timely and medically necessary care and medications and reduce the administrative burdens. More than 100 other healthcare organizations support those principles. Now, the AMA has released the results…
Supply & Demand: Where Will the Rheumatology Workforce Be in 2030?
According to the “2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015–2030,” the demand for rheumatologic care is projected to exceed supply of clinical adult rheumatology providers by 4,133 clinical FTEs by 2030. The research now being published estimates the baseline adult rheumatology workforce, as well as determined demographic and geographic factors relevant to the workforce. The research also highlights the need for innovative regional strategies to manage future access to and reduce barriers to care for rheumatology patients in underserved regions…
Rheumatology Coding Corner Answer: Follow-Up Knee Injection
Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale CPT Codes: 20610-LT, J7325x16 ICD-10 Code: M17.12 This claim is rejected by the insurance carrier because the injection was outside of the preauthorization window that ended on Oct. 31. Most insurance carriers enforce their preauthorization dates for procedures. In…
Rheumatology Coding Corner Question: Follow-Up Knee Injection
On Nov. 4, a 55-year-old female patient presents to the office for a follow-up visit for injection of the left knee for osteoarthritis. This is her third of three injections that were preauthorized through Oct. 31. She reports pain and swelling in her left knee and rates the pain at an 8 on a 10-point…
5 Steps to Help You Manage Prior Authorizations
Despite continuous movement to streamline the prior authorization process, physician practices are still struggling with jumping through hoops to have procedures and medications covered. A prior authorization (PA) is the process insurance carriers have in place to approve or reject prescriptions based on plan formulary. The PA process is important in ensuring appropriate and cost-effective…
The Smartphone as Diagnostic Tool
SAN DIEGO—Increasingly, technological advances are placing new tools into the hands of office-based rheumatologists. And they don’t have to cost a lot in capital equipment outlays by the medical group, because some of the best advances can be accessed via the device that is already in most doctors’ pockets, their smartphone. Smartphone technology gets more…
Rheumatologist Fellow Works in India Via ACR Exchange Program
In November 2017, I went to Lucknow, India, where I would spend my time as an exchange fellow at the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPIMS) as part of the ACR International Visiting Fellows Exchange Program. Where I Come From I completed my medical degree at Mahatma Gandhi Missions Medical College, Navi Mumbai…
Providers Using RISE Have Advantage with 2017 MIPS Reporting
Hundreds of rheumatology providers across the country are finalizing submissions for the first year of reporting under the Merit-Based Incentive Payment System (MIPS). According to a presentation at the 2017 ACR/ARHP Annual Meeting in San Diego, providers that participate in and submit through the Rheumatology Informatics System for Effectiveness (RISE) Registry are poised to perform…
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