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…
How to Attract Medical Students & Rheumatology Candidates
As the shortage of rheumatologists is expected to worsen, practices and fellowship programs are asking how to attract top talent. Here are tips for how individuals can raise rheumatology’s profile and reach out to med students and new rheumatologists…
Priority List Could Help Produce Better Pediatric EHRs
NEW YORK (Reuters Health)—Children’s electronic health records (EHRs) are missing functions “essential” for managing children’s health, according to a multistakeholder work group that produced a “high-priority” list of EHR requirements. “Most doctors caring for children in hospitals or office practices now use EHRs, which benefit children and families by offering decision-support and other safety features…
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