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Articles tagged with "insurance"

Should Patients with Rheumatic Disease Switch from Biologic to Biosimilar?

Susan Bernstein  |  January 19, 2018

SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…

Unwise Choices: EHRs, PBMs, Drug Costs Are Leading to Physician Burnout

Simon M. Helfgott, MD  |  November 5, 2017

My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…

Prepare Now to Sell Your Medical Practice

Steven M. Harris, Esq.  |  August 15, 2017

Selling a medical practice can be a lucrative endeavor. One of the most important phases of any sale transaction is the due diligence process. During this phase, a potential buyer and their advisors have the opportunity to examine the seller’s books, records and files in great detail to ensure that the buyer is comfortable purchasing…

Succession Planning Tips for Rheumatology Practices

Kurt Ullman  |  August 13, 2017

Physicians are no more likely than other people to want to think about what happens next. The question of who takes over for a doctor due to death, disability or retirement has legal, medical and personal implications and requires planning to ensure the succession goes smoothly. “Succession planning is like an advance directive for the…

Undercoding Is Not an Audit-Proof Strategy in Medical Documentation

From the College  |  March 20, 2017

Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…

Rheumatology Research Abstracts Highlight Treatment for Hand OA, Risk of Depression in Lupus and More

Mary Beth Nierengarten  |  February 15, 2017

WASHINGTON, D.C.—What do treating hand osteoarthritis (OA) in the primary care setting, high financial strain and risk of depression in patients with lupus, prolonged sitting and cardiovascular disease, and sex-specific treatment after total hip arthroplasty have in common? They were all topics presented during a session titled ARHP I: Exemplary Abstracts at the 2016 ACR/ARHP…

The ACR Insurance Subcommittee Advocates for Fair Payer Policies

From the College  |  January 17, 2017

The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…

Opinion: Insurance Companies Use Medically and Fiscally Irresponsible Formularies

Bruce Rothschild, MD  |  October 14, 2015

Receipt of an unsolicited communication that a sweepstakes award has been won may con some people (especially, but not limited to, those underprivileged or undereducated as to legalities), but can’t fool all of the people all of the time. The names of the organizations and products involved are often marketing tool inventions, which imply special…

What the Healthcare System Can Learn from the World of Bees

Rick Brasington, MD  |  November 1, 2014

Bees’ natural instinct to promote health of whole colony could inspire healthcare professionals to work together toward common good

Are Insurance Companies’ Medication Directives Fiscally, Medically Questionable?

Bruce Rothschild, MD  |  November 1, 2014

A reader questions whether insurers’ practice of promoting medications has undermined physicians’ ability to provide quality patient care

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