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Search results for: health insurance

ACR Leaders Outline Advocacy Victories, Threats

Thomas R. Collins  |  October 22, 2018

CHICAGO—ACR leaders described a series of looming legislative and regulatory threats to rheumatologists and their patients—including the proposed collapsing of evaluation and management (E/M) coding and potential changes to step therapy rules—and urged everyone in the field to make their voices heard to quash the proposals. They also recounted recent victories in the policy realm…

Filed under:American College of RheumatologyLegislation & AdvocacyMeeting Reports Tagged with:2018 ACR/ARHP Annual Meetingevaluation and management (E/M) codinglegislative and regulatory threatsstep therapy

Improve Your Claim Submissions Process

From the College  |  October 18, 2018

Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as…

Filed under:Billing/CodingFrom the CollegePractice Support Tagged with:claimsMedicare

Coding Corner Answer: Rheumatology Coding & Practice Quiz

From the College  |  October 18, 2018

Take the challenge. B or D—If it was not documented, it was not done is the motto of many coders. For those who follow this motto, the answer would be B. But there is another option for the coder and that is to query the physician about whether the injection was done with ultrasound guidance…

Filed under:Billing/CodingFrom the College Tagged with:Billing & Coding

Big Data May Shift Reference Ranges for Some Lab Tests

Susan Bernstein  |  October 18, 2018

How will big data mined from huge sample sizes in research cohorts, electronic health records, personal health data (e.g., heart rates from Fitbits) and insurance claim data sets change the way physicians interpret something as simple as complete blood count (CBC) test results for individual patients? According to the authors of a paper in the…

Filed under:Technology Tagged with:big datalab test

Registered Nurses Provide Valuable Support to Rheumatology

Karen Appold  |  October 15, 2018

In a rheumatology practice, registered nurses take on multiple roles, from administrative tasks to engaging in patient support and assessment. They can aid rheumatologists and help provide the best care to patients…

Filed under:Practice SupportWorkforce Tagged with:patient carePractice Managementregistered nurse

Aetna, Seeking Antitrust Nod, Sells Medicare Drug Business to WellCare

Reuters Staff  |  September 27, 2018

(Reuters)—Health insurer Aetna Inc said on Thursday it will sell its standalone Medicare prescription drug plan business to WellCare Health Plans Inc as it seeks U.S. antitrust approval for a planned acquisition by CVS Health Corp. The $69 billion CVS-Aetna deal would be the second large deal this year between insurers and pharmacy benefit managers,…

Filed under:Uncategorized Tagged with:Aetna Inc.CVS Health CorpMedicare prescription drug plan businessU.S. antitrust approvalWellCare Health Plans Inc

Fellows Find Their Voices on Capitol Hill

Kelly Tyrrell  |  September 24, 2018

In 2015, as a rheumatology fellow, Christina Downey, MD, attended the inaugural ACR Advocacy 101 course, put on by rheumatologists Blair Solow, MD, and Sarah Doaty, MD. “I thought it was incredibly informative, and I was really surprised at how much legislators and staff did not know about rheumatology, or what it’s like to be…

Filed under:Education & TrainingLegislation & AdvocacyProfessional Topics Tagged with:Advocacy 101Advocates for Arthritis

ICD-10 Code Change Proposed

From the College  |  September 24, 2018

On Sept. 12, the ACR and the Sjögren’s Syndrome Foundation presented an ICD-10 code change request for Sjögren’s syndrome to the ICD-10 Coordination and Maintenance Committee (C&M) at the CMS office in Baltimore. The request is intended to clarify ICD-10 M35.0: sicca syndrome [Sjögren]. Why Change the Code? The rationale behind this significant change request…

Filed under:Billing/CodingConditionsFrom the CollegeSjögren’s Disease Tagged with:ICD-10 code change requestsicca syndromeSjogren's

Advocates for Arthritis Push for Policy Changes at Annual Event

From the College  |  September 24, 2018

The ACR advocates on behalf of the rheumatology community throughout the year, but it’s always especially exciting when patients join our efforts in Washington, D.C. Close to 100 patients, rheumatologists and representatives of the broader interprofessional team traveled to our nation’s capital this week to participate in the ACR’s annual Advocates for Arthritis event. Participants…

Filed under:American College of RheumatologyFrom the CollegeLegislation & AdvocacyProfessional Topics Tagged with:Advocates for ArthritisAssociation of Rheumatology Professionals (ARP)Department of Defense (DoD)dual-energy X-ray absorptiometry (DXA)Medicare evaluation and management servicesRestoring the Patient’s Voice Act (H.R. 2077)step therapy

Is Concierge Medicine Right for Your Practice?

Steven M. Harris, Esq.  |  September 20, 2018

It is no surprise to practicing physicians that the healthcare landscape is becoming more and more unpredictable. Because of the volatility surrounding today’s healthcare environment, such as increasing overhead costs and decreasing reimbursement rates, many physicians are asking themselves whether there is a different, more lucrative way to practice medicine. Concierge medicine may just be…

Filed under:Legal UpdatesPractice Support Tagged with:boutique medicineconcierge medicineretainer medicine

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