Concerned about reimbursement for specialty drugs? Wondering if your patient can continue on a prescribed medication despite formulary changes? Unsure how to request a tier exception? No need to face these issues alone. The ACR has a resource that can assist with questions regarding coverage and payment policies for private insurers and Medicare. That resource…
As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
Take the challenge. D—As of January 2015, there are three new codes added to the arthrocentesis codes of 20600–20611. The new codes, 20604, 20606 and 20611, should be reported when the procedure is performed with ultrasound guidance and CPT 76942 should not be billed separately. The three new codes are defined as: 20604—Arthrocentesis, aspiration and/or…
To be an effective practice owner, it is necessary to understand the financial circumstances and environment of the practice’s operation. Well-managed practices prevent the loss of time and money. Therefore, to improve productivity and operating efficiencies, you need to have a basic understanding of billing and payment initiatives that will impact the practice’s bottom line….
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
“Burnout? In rheumatology fellowship? You’re kidding me, right?” That was the response of one of my very good friends from residency who is now a cardiology fellow, when I told him that I was concerned that one of my co-fellows, at another institution, was on the verge of burning out. Stepping back, I could understand…
In 2014, the ACR launched the Rheumatology Informatics System for Effectiveness (RISE), a national electronic health record (EHR)-enabled registry. The goal: To help participating rheumatologists and practices leverage the new wave of big data created by the use of EHR, advance research and improve overall quality of care. A new analysis examines the RISE structure and the initial patient data collected by the registry…
The ACR can be the first line of defense for rheumatologists when it comes to compliance efforts, quality control and oversight of physician billing and coding practices, says ACR Director of Practice Management Antanya Chung, CPC, CPC-I, CRHC, CCP. The ACR is focused on providing the support its members want and need. “We want to…