The ACR Proactively Works to Improve the Physician Practice.
Through the work of the Committee on Rheumatologic Care and its subcommittees, the ACR proactively works to improve the physician practice.
The Business Side of Medicine Publications
Two new online resources devoted to the business of running a successful practice were published:
The Business Side of Rheumatology is a practical business manual for rheumatologists and practice administrators on starting, selling, or redesigning a rheumatology practice.
The Rheumatology Coding Manual is a reference guide for rheumatologists and their staff to assist in properly coding rheumatology office visits and procedures, and how to communicate effectively with third party payors.
Additional publications designed for those in practice are under development and scheduled for release in 2011.
Focusing on Payer Advocacy Initiatives
The Model Biologics Policy was created in 2010 and distributed to over 2000 insurance companies to encourage them to follow a policy created by rheumatologists for rheumatology patients. In 2011, the ACR will compare national policies with the Model Biologics Policy to encourage insurers to adopt policies aligned with the ACR's policy.
Also created in 2010 was the one-page prior authorization form to reduce the burdensome paperwork associated with prescriptions. This form was distributed to insurance companies to encourage adoption nationwide. The ACR is also working with the American Medical Association and other societies to create one one-page form that can be printed from electronic health records.
Through face to face meetings and events like the Insurance Roundtable session at the ACR/ARHP Annual Scientific Meeting, the ACR will continue to proactively work with insurance companies to provide reliable information on draft medical policies, appropriate information on policy and program development and a mechanism to understand issues relating to rheumatic disease.
Members with insurance issues were also regularly encouraged to complete the ACR's health plan complaint form so staff can intervene. The form is located on the ACR website under practice management and insurance issues.
The Certified Rheumatology Coding Course and Examination
One way to ensure a practice is claiming every dollar per patient visit is to have qualified coding and billing staff. Developed in 2010 in conjunction with the American Academy of Professional Coders, the Certified Rheumatology CoderTM specialty credential demonstrates a superior level of coding expertise in the field of rheumatology and validates a person's ability to assign the correct codes. Many coders have already received the new certification!
ACR staff delivered 10 coding, audit and certification presentations at state society meetings throughout 2010. These presentations are available free to members. If you would like to have an ACR coding specialist come to your area contact or learn more about the program online.
Creating Opportunities for Affiliate Societies
The Affiliate Society Council, which now represents 24 state societies, meets twice a year and communicates regularly with the ACR on important practice issues, such as patient-centered medical homes, comparative effectiveness research and numerous insurance issues. This important two-way communication continued throughout 2010 on a variety of reimbursement and insurance issues.
Continuing the Health Policy Conversation
As in previous years, ACR staff and volunteers attended coding and health policy meetings to ensure that rheumatology issues were appropriately addressed. These meetings included American Medical Association, CPT, RUC, ACP Council of Subspecialty Societies, ACP Subspecialty Advisory Group on Socioeconomic Affairs and AMA House of Delegates meetings. Having a continued presence these meetings ensures the voice of rheumatology is heard.
Handling Federal Issues that Affect Rheumatology
The ACR continues to monitor the Federal Register and regularly submits comments regarding the Centers for Medicare & Medicaid Services rule, specifically regarding Accountable Care Organizations. The ACR continues to work on the elimination of consultation codes along with other affected specialty societies to combat the exclusion of reimbursement for these codes. To learn more about how the ACR is advocating on the federal level, read the 2010 Accomplishments in Advocacy.
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