The ACR offers members a number of resources to assist with various insurance problems and inquiries. Below there are tools and frequently asked questions for approaching some of the most common insurance and payment issues. If you would like assistance with an issue not included below, please contact practice@rheumatology.org. To view the current top insurance advocacy issues, please visit our current issues page.
Off-Label Drug Use Letters
These letters can be used as templates to assist in getting approval for off label uses that are common in rheumatology practice.
Pediatric Letters
Grievances, Complaints, Insurance Denials
Additional Resources
ACR Position Statements: The ACR issues position statements on issues that are important to the practice of rheumatology. Frequently, these position statements address barriers to patient access and may provide helpful information for securing health plan approval for a particular treatment.
Model Biologics Policy: The ACR's Model Biologics Policy can be used nationwide to reduce administrative burden among rheumatologists, patients, and insurers and allow physicians to properly treat patients without administrative delays.
ACR Clinical Practice Guidelines: The ACR develops Clinical Practice Guidelines to reduce inappropriate care, minimize geographic variations in practice patterns, and enable effective use of health care resources.
Audit Programs: Learn about the Federal government’s audit programs to ensure correct payments to providers and suppliers in the Medicare Fee-for-Service program. Also see information on how ACR staff can assist with your coding and billing questions.
Medicare: Resources to assist with Medicare issues including the current Physician Fee Schedule.
Protect Access to Physician-Administered Treatments One-Pager: Important medications used to treat rheumatologic and other inflammatory conditions. These treatments are life changing for patients and it is critical that these are administered by the provider in an office setting to ensure high quality access to care for patients.