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Joe Jacobs, MD
Chair, ARS Patient Advocacy Committee
Stephen Marks, MD; Brent Senior,MD; Winston Vaughn, MD; and Dan Becker, MD
ARS Patient Advocacy Committee
Patient Advocacy issues unfortunately continue to require a significant amount of expenditure of both time and money within the American Rhinologic Society and the Patient Advocacy Committee. This issue of the ARS Nose News contains material, which all otolaryngologists need to take notice of since it appears the forces, which are presently constraining our practice patterns and diminishing reimbursement, are gathering for a second wave of assaults.
The specialty societies within the academy are beginning to carry the burden of reviewing and documenting the practice expense components relating to medicare reimbursement. Dr. Mike Sillers of the ARS Board has provided an in depth view of this process. Many of us will need to become actively involved in this task to avoid a major change in reimbursement relating to rhinologic codes.
Both the ARS and the AAO are both addressing issues concerning the utilization of CPT 31237. Click here for more info and click here for follow-up info. As you probably know the ARS has aggressively defended this code and has retained a legal team at Hogan and Hartson in Washington, D. C. to actively pursue carrier denials. There exists significant documentation within the ARS website, that can be utilized on a local level to contest third party payor disputes. The Board of Governors involvement is provided by Richard W. Waguespack who is actively involved in the Academy CPT process. Both Dr. Waguespack and Dr. Schreibstein fully discuss the introduction of S codes which appear to represent another means of ultimately reducing reimbursement through manipulation of the system by the third parties and their representatives. The ARS will be actively investigating this additional and complex issue and will without question aggressively defend our position.
Please feel free to contact me at joseph.jacobs@med.nyu.edu or 212-263-7398
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