Podiatry is a medical specialty that focuses on the diagnosis and treatment of human feet and ankles. Podiatry billing faces unique challenges and requires expert skills and in-depth industry experience that general billing service providers cannot provide. Every year, podiatrists lose about 20% of their potential revenue due to billing, according to research. With ongoing healthcare reforms and rising medical costs, physicians are finding it challenging to maintain healthy revenues while providing quality care. Podiatrists are badly affected by rising costs and must improve their billing practices to remain financially viable in the future.
Podiatry billing can be complicated in many ways, from determining and proving the medical necessity of the treatment to the numerous nuances of medical coding. It requires the thorough use of modifiers and an understanding of coding for inclusive processes. Podiatry billing requires the most knowledgeable billers and coders who are up to date on the most recent revisions to billing needs, code-specific regulatory requirements, and compliance requirements. Unskilled billing staff and ineffective billing practices can create problems in your practice’s RCM process. Outsourcing podiatry billing can maximize claims payments and keep the practice in compliance with government regulations. Accurate and consistent coding is essential for obtaining successful billing returns and reimbursement for all patient care given. The recommendations below can assist you in accomplishing this goal and increasing collections for your Podiatry practice.
Here are 6 ways to improve your podiatry billing process
Use the Appropriate Billing Codes
Proper medical codes are critical in optimizing podiatry billing services. Insurance companies learn about a specific injury, diagnosis, illness, treatments, medical procedures, and service provided by a patient during his visit. Coding errors, such as unbundling, upcoding, under-coding, and incorrect modifiers prevent payers from receiving payments for an extended period. Furthermore, healthcare providers may lose reimbursement indefinitely. In some cases, healthcare professionals may face federal consequences, heavy fines, license cancellation, and imprisonment. Because some coding mistakes are regarded as malpractice or billing fraud. As a result, physicians should never depend on unskilled medical coders. They must hire certified coders who are well-versed in the most recent coding classifications, such as ICD-10, CPT, and HCPCS.
Get Proactive About Claims Scrubbing
Uncleans claims increase the chance of rejection. When you submit a good, clear claim, the billing process runs smoothly, and you are compensated for the initial claim submission. Claim scrubbing is the process of scanning for and detecting incorrect billing features for podiatrist practices using electronic tools. The claims scrubbing tools help in the prevention of human error, which is not unusual. Reworking claims cost an average of $25. For every 100 rejected claims, you could lose $2,500. A massive percentage of denied claims are due to a lack of understanding or failure to update the claims. A good claim-scrubbing process will ensure that no claims are rejected. When claims are rejected, you should have a procedure in place. Otherwise, you are leaving unclaimed cash hanging in the balance, with only a limited time to claim it.
Discuss the procedure for dealing with a rejected claim with your practice’s medical billing staff. To avoid rejections, ensure that the billing practitioners in your office are aware of the podiatry billing tips. Furthermore, if your podiatry practice is using an excellent EHR solution, you will be notified as soon as claims are denied. Furthermore, you can use data analysis reports to determine how many rejections you may have to revamp at any given time.
Conduct Audit Regularly
Once a company establishes a regular audit schedule, it can recognize trends and areas of error. Regular auditing helps to identify major flaws in billing and coding, allowing you to evaluate your staff’s expertise. Staff education will help to reduce errors. Regular auditing of records can facilitate communication among medical personnel such as auditors, coders, billers, nurses, and healthcare professionals. This will allow for more discussion and questioning about the quality of patient care and how to improve it.
High documentation precision and the correction of common flaws boost the overall quality of claims. External audits will decrease the chances of your claims being denied. This will result in faster reimbursement, more revenue, and better compliance. Because of their complexity, coding and billing errors in podiatry may appear unavoidable. Regular audits can assist in determining the percentage of errors while also assisting in the analysis of their causes. It ensures that consistent stages are taken to reduce repeat errors. The audit also allows you to consider your staff and provide them with additional training or preparation.
Collect Patient Information Carefully
It has been noted that failing to collect accurate and complete patient data slows down podiatry billing services and results in claim denials. To eliminate the underlying reasons for revenue loss, registration staff must verify all of your patient’s data. Such as their policy figures, date of birth, name, gender, and other basic information. This data must be kept up to date to prevent any disadvantage from claim denials. Furthermore, healthcare professionals should hire highly trained personnel to carry out front-end tasks efficiently. However, despite technological advancements, the majority of healthcare providers continue to rely on manual processes for maintaining patient records, data collection, and communicating with back-end staff. Using such conventional techniques increases the likelihood of human error and can result in claim denials.
The implementation of advanced Electronic Health Records is the best solution to enhance clinical documentation performance. Using EHR solutions is the most effective way to keep the patient’s record digital. It can help your podiatry business in the following ways:
- Offers reliable, up-to-date, and comprehensive patient information.
- Allow healthcare providers to easily access patient records in a more organized way.
- Improve the effectiveness and accuracy of medical documentation.
- It helps in the communication between patients and healthcare providers.
- Protect extremely confidential information from loss, unauthorized access, and other threats. Implementing EHR can lead to fewer denials and faster reimbursements.
Pre- Authorization
The insurance verification and the pre-authorization process are critical to the success of podiatry practice. The most crucial step in ensuring a successful practice is outlining the patient’s advantages and coverage for certain medical treatments before the point of service. Many non-emergency medical procedures and services require pre-authorization or prior clearance to be reimbursed. Failure to gather this information may result in delayed reimbursements, the requirement for claim revision and resubmission, errors and nonpayment, and other consequences for your practice.
Set Clear Payment Terms
Assume you’ve already taken the first step and determined that your patient’s insurance will cover your services with an $80 copay. You’ll want that $80 from the patient as quickly as possible. Take the following steps to make it happen to indicate what patients owe, as well as when and how they must pay. Don’t presume that patients will know the amount of their copay when you check them in. Instead, inform the patient that they have a copay and demand payment at the time of check-in. Request advance payment, but be flexible if the patient cannot pay right away.
Create a workflow for patient interactions. Assume a patient is unable to pay their copay at the time of their visit. In that instance, you must maintain contact with the patient until they pay. You can do so by sending payment reminder letters or sending electronic reminders. If you choose the electronic way, automate the distribution of these reminders depending on the patient’s payment history. When patients are unable to pay in full right away, monthly payment plans may be an appropriate option.
As needed, send patient statements. Ideally, your patient will have to pay a copay and their insurance will cover the rest. But that is not usually the case in reality. If the insurer rejects some or all of the claims, the patient is responsible for the balance. Send patient statements outlining the claim and which portions the insurer refused to pay. For more information, the insurer should give the patient an explanation of benefits (EOB) along with the statement.
How Can You Optimize Podiatry Billing And Coding?
Human error and oversight are clear. However, there is a backup plan: outsource podiatry billing and coding professionals to manage your bills. Any reputable podiatry billing service offers full-service solutions, such as automation to eliminate claim errors, trustworthy carrier follow-up to ensure full payment, and tailored reports to give you real-time visibility of your company’s financial health. That is what it means to make the most of your reimbursement.
Your coding and billing accuracy will improve if you implement the podiatry coding recommendations mentioned above. Optimizing the podiatry billing service while offering great care to patients is not easy for healthcare practitioners. Because recent improvements in medical coding and billing, as well as strict standards set by insurance companies and regulatory authorities, have enhanced the complications of podiatry billing services. As a result, they are unable to maintain their revenue cycle management on track without the assistance of a professional billing team. So, rather than investing time and money in hiring expert billers, coders, office space, and the acquisition of cutting-edge billing systems, healthcare providers should outsource their podiatry medical billing services to a reputable third party.
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