6 Unique Tips to Master Podiatry Billing

Did you recently open a podiatry clinic and are looking forward to welcoming patients and increasing revenue? First of all, congratulations! And second, you don’t just need a degree and a passion for podiatry to succeed in the profession. 

Even though your profession is challenging enough already, you need to take care of certain legal and fiscal aspects. And one of the most complex of them is podiatry billing. On average, the doctors of Podiatric medicine in the US receive 60 million visits a year from patients of foot diseases. With the number of patients growing every day, the stress of billing increases too. 

But this article will help you ease some of that stress. Read on for some important tips and tricks to master podiatry billing nuances.  

Essential Tips for Podiatry Billing

Correctly Using Billing Modifiers

Filing accurate claims is vital for podiatrists. Because unless you do that, you will run into both legal and financial trouble. And one great way to avoid claim denial is using suitable modifiers in the proper manner.  

For example, suppose you performed a non-routine procedure on a patient. In that case, you will have to demonstrate the procedure’s necessity. To do this, you might have to include additional paperwork that shows why the procedure was mandatory. But in general, adding the correct modifier with the billing code can do the job. 

Find out the correct modifier for the procedure you have performed and use it while billing. Some examples of key modifiers in podiatry billing include Q9, Q8, GX, Q7, etc. However, remember to not overuse modifiers, or you might receive constant denials. 

Insurance Verification

Insurance verification involves checking the patient’s active coverage with the medical insurance company or Medicare. This can help you understand whether the procedure will be reimbursed later or not. For example, many routine foot care procedures or treatments for flat feet aren’t covered by Medicare.

Moreover, accessing and verifying the eligibility of the insurance claims matters too. Don’t forget to do so with the insurance ID number, patient’s name, date of birth, insurance phone number, and so on. All these are important for getting reimbursement, reducing denial rates, and boosting cash flow.

Patients need to know their payment responsibilities while scheduling appointments. This will help to avoid last-minute cancellation as the patient can decide whether they are ready to bear the cost of treatment or not. So correctly verify the insurance info and present it to the customers after initial consultations.

Stay Updated With All the Codes

World Health Organization has formed the International Classification of Health Interventions (ICHI) to standardize the classification process. Right now, the billing codes are different in every nation. In the US, typically, 10,000 CPT codes are used. You have to use the right CPT, HCPCS, and ICD-10 codes for reporting the diagnosis and treatment. 

Keep the billing department updated with changes in the coding standards and guidelines. Because even a simple or small error can lead to late payment or refusal of claims. To stay updated with the codes, you can regularly check the WHO or CDC guidelines on their websites. You should also check in with Medicare to find out additional fees and policy changes.

However, constantly studying these guidelines is often a big hassle, which is why podiatrists choose to outsource the billing responsibility. If you are looking for a reputed podiatry billing service provider, Hippocratic Solutions is a popular name. Contact them if you need any assistance with the billing procedure. 

Podiatry Billing For Complicated Conditions

 While filling up the podiatry form for claiming and follow up of a complicated foot condition, you must be careful about the following:

• Make a proper document with the physician’s name (the one who initially diagnosed the patient), the patient’s name, visit date, diagnostic procedure, and how critical the condition is. Also, note the last appointment date of the patient with the said physician.  

The severity of the problem must not be ignored while making a bill. So be extra careful while documenting that.  

Inclusive Services

Often, a podiatry billing claim can be denied because the procedure performed on the patient was noted as inclusive. 

To avoid such hassle, do not bill CPT codes 11719, 11721, and G0127 altogether. But if you have already done so and the claim has been denied, make suitable edits before appealing. 

Remember, such mistakes will harm you and your patients. So verify and recheck all bills before finalizing them. 

Appeal on Denial 

Even after documenting everything appropriately, you still have the chance of getting your claim denied. So, ensure to go through the Explanation of Benefits (EOB) you have received. It will provide you with the primary reason behind the denial of your claim.

After knowing the reason, mention it while appealing and address any mistakes you may have made in that regard. You might have missed adding some crucial information. In addition, check the policy of the insurance provider. 

In the United States, non-covered services, even if performed by a podiatrist, won’t be reimbursed. So if you’ve wrongly filed for such a claim, do not appeal the denial. 

Conclusion

Podiatry billing is complicated, but the tips above will surely simplify some basics of it. With care and precision, you can soon master podiatry billing. But if you cannot get the hang of it even after repeated tries, hire an expert podiatry billing service provider instead of risking denials again and again.