The ACR practice management department actively works to provide valuable, accessible resources for rheumatologists and their staff in addressing practice issues on a local and national level. Our trained professionals are devoted to providing the most up-to-date tools and resources to help improve practice efficiency while meeting the myriad compliance obligations of the ever-changing healthcare landscape.
The practice management resource center is designed to assist with such issues as coding and billing guidelines, office compliance, documentation, and denials management, as well as understanding the intricate details of working with Medicare, private insurers, and even self-pay patients.
Practices can receive assistance and gain solutions to practice management, coding, and billing issues by visiting rheumatology.org/Practice-Quality. Key resources include:
Advanced Rheumatology Coding & CDI Boot Camp
The Advanced Rheumatology Coding and CDI Boot Camp provides physicians, coders, billers, and practice managers with in-depth education on new and changing documentation requirements needed to fulfill the clinical criteria necessary for appropriate code assignment to ensure quality patient care. The ACR certified coders and CDI specialists will conduct this eight-hour course with an overview of key coding guidelines, physician documentation requirements by body system, and understanding of the ICD-10 and procedural coding structure, and discuss changes to the guidelines in ICD-10-CM for frequently reported diagnoses. Participants leave class ready to maximize documentation efforts for diagnoses and E/M and procedural codes commonly targeted by third-party and government payers.
The rheumatology-specific Coding and CDI Boot Camps are offered around the U.S. at various locations. For a list of upcoming courses, contact the practice management department at [email protected]. Additional coding and billing resources can be found at rheumatology.org/Practice-Quality/Administrative-Support/Coding.
Evaluation & Management Chart Auditing — Avoid Audit Risks
As required by the Tax Relief and Health Care Act of 2006, CMS has implemented Medicare recovery auditing in all states. This, along with the Office of the Inspector General’s (OIG’s) 2017 semiannual report on recovering over $2 billion in overpayment, means that the claims auditing movement is now moving forward at full speed. This hands-on training program is designed to assist rheumatology practices in recognizing the essential steps in identifying documentation improvement and coding risk areas before a third-party or government audit. For more information on self-auditing or to schedule an on-site meeting, contact the ACR certified healthcare auditors at [email protected].
In-depth information on CMS auditing and program integrity can be found at rheumatology.org/Practice-Quality/ Administrative-Support/Practice-Resources/Audit-Programs.
Certified Rheumatology Coder Review Course & Exam
The Certified Rheumatology CoderTM (CRHCTM) exam is designed to provide learning and thoroughly test the coding knowledge of professionals in rheumatology, including physicians, coders/billers, office managers, administrators, consultants, and other health professionals. The ACR’s practice management department will send their PMCC coding instructor to conduct a day-long review course and administer the three-and-a-half hour exam at several different locations throughout the U.S. To review the certification guidelines or register for a course, visit rheumatology.org/Learning-Center/Educational-Activities.
Business Side of Rheumatology
A practical online business manual for rheumatologists, fellows-in-training, and practice administrators on starting, selling, or redesigning a rheumatology practice.
Rheumatology Coding Manual
This electronic coding reference is a practical guide for rheumatologists and their staff to communicate effectively with third-party payers regarding the medical services provided to patients. The ACR Rheumatology Coding Manual can also be used by practices as a hands-on tool for new clinical and coding staff to familiarize themselves with rheumatology coding.
The ACR provides online letter templates addressing the ACR’s position on proper reimbursement practices for rheumatology services. Additionally, the ACR sends letters on behalf of members to insurance companies concerning payment and policy issues affecting rheumatology practices.
Health Plan Complaint Form
In an effort to better assist in addressing both individual and system-wide insurance issues, the ACR developed a standardized complaint form, which can be completed and submitted to the ACR for assistance.
The ACR practice management department works with the ACR education department to provide sessions during the ACR/ARHP Annual Meeting. This year, two pre-meeting courses were offered: ACR Coding: Unlock the Mysteries of Advanced Coding for Rheumatology on Oct. 19 and ACR Practice Management: Putting the Pieces Together: Winning Strategies for Rheumatology Practices on Oct. 20. These sessions covered coding guidelines for medical necessity, revenue cycle management, marketing, contract negotiations, and office management, which are pivotal for on-going achievement and success in rheumatology practices. Visit rheumatology.org/ Annual-Meeting for more information.
The ACR places a concentrated focus on the importance of continuing education in coding and practice management. Rheumatology practice administrators and managers must pay close attention to financial management, compliance issues, and billing and coding changes. The ACR is in the perfect position to provide appropriate education and training for rheumatologists and their staff to run an effective and efficient practice.
Stop by the coding and practice management kiosk in the ACR Discovery Center (located in the Exhibit Hall) to talk with the ACR coders and certified auditors for all your coding and billing questions, or to set up a coding course in your area.