A medical specialty such as podiatry is constantly facing medical billing challenges due to the dynamic medical landscape. This creates a demanding medical billing environment for healthcare providers.
The busy daily routine of healthcare providers leaves very limited time. Hence, they have to make a choice and opt for in-house billing staff or podiatry billing services. This enables a helping hand that solves crucial issues such as intricate billing and coding.
The most beneficial method that helps healthcare providers is medical billing services so that podiatrists can focus on the diagnosis and treatment of foot ailments.
A podiatry medical billing company assists at every step of medical billing while optimizing revenue cycle management. The expertise and skill of a professional outsourcing partner minimize the inaccuracies and maximizes the reimbursement.
As a healthcare provider, making this choice and shifting to medical billing services can be a huge leap. That is why, in this blog, we will discuss the medical billing challenges of podiatry practice and the best exercises to tackle this concern.
The very first step for healthcare providers is to understand the problematic areas, and only then will they be able to make an informed decision.
Major Complexities in Podiatry Medical Billing
Here are the major challenges that podiatrists face while managing their administration to receive adequate revenue for their services to the patients.
Need to Verify Insurance Coverage
Insurance verification is intricate due to the wide scope of insurance policies and regulations. Another reason that makes it complex is that both private insurance companies and Medicare have regulations for podiatry.
From estimating the patient’s financial responsibility to acquiring the required authorizations, insurance verification makes the road to efficient medical billing a challenge.
It becomes a necessity for healthcare providers to know the policies and carry out the verification process successfully. This step is essential for accurate documentation and other steps in the revenue cycle as well. Other than that, the clean claims rates are highly dependent on effective insurance verification.
Managing all this can be burdensome for healthcare providers, making them consider podiatry billing services.
Need to Fulfill Billing Regulations
As the healthcare landscape is constantly evolving, it is subject to many changes. Almost all the changes are regulatory changes. The frequent introduction of new rules and guidelines regarding coding, documentation, claim submission, and claim processing.
Healthcare providers must stay current with these changes to avoid falling behind in the podiatry medical billing process. However, this is not easy and often healthcare providers fail to stay up to date.
However, tackling this challenge is vital for healthcare practice. This is also important to avoid coding errors and denial of claims.
Need for Accurate Documentation
The shortcomings in documentation further lead to coding errors and finally result in denials. The whole process gets distorted, and authenticity is affected. In podiatry as well, accurate documentation is a must to ensure a smooth medical billing process
What makes podiatry documentation difficult is the need to maintain the documentation of patient entries, diagnosis, procedures, and medical necessity. The defects in the documentation can be the reason for claim denials and can affect the reimbursement.
That is why it becomes vital to ensure accuracy while documenting the relevant information and details regarding the treatment procedure.
Documentation is not just recording basic patient data. It extends to recording patient history, treatment plans, and personal details as well. The possibility of human errors is high compelling healthcare providers to opt for podiatry billing services.
Need for Precise Coding
Podiatry is a full-fledged medical specialty, and this is the reason for its specific coding requirements. The wide range of podiatry procedures includes fractures, sprains, infections, diabetic foot, and more. There are other treatments such as hammertoe correction, Achilles tendon repair, bunionectomy, and many more.
There are other surgical and non-surgical procedures as well. All these procedures are converted into appropriate medical codes, and it is vital to allocate the right code for every treatment. Mistakes and drawbacks lead to errors and further result in revenue leakage.
The number of treatments can be a strong reason for mistakes in medical coding. However, it is a must for healthcare providers to either know all the codes or have a coding team that is precise in all the codes for podiatry procedures.
Some of the common podiatry procedures are Neuroma surgery, Ankle and Heel surgery, Arthroscopy, Metatarsal surgery, Plantar fasciotomy, Flatfoot correction, Toenail procedures, Foot lesion removal, Limb amputation, etc.
Need for Coding Compliance
Knowing the podiatry codes is not enough to successfully handle the podiatry medical billing. Healthcare providers must take care of coding compliance as well. The two main organizations that set the coding guidelines for podiatry are the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). Healthcare providers are supposed to stay current with coding guidelines issued by these organizations. Regular updates and compliance requirements add to the challenge of podiatry medical billing.
In this case, there is a need-to-know podiatry-specific CPT and ICD-10 codes along with appropriate modifiers. There can be a requirement to use multiple modifiers along with single procedure codes. Coders must be completely aware of when and how to use modifiers with CPT codes.
Need to deal with Denials and Rejections
Claim denials are not uncommon but they are the cause of complexity in podiatry medical billing. The major contributors to denials are errors and mistakes in coding, incorrect or missing documentation, or lack of awareness in policies.
It becomes important to navigate through the denials and reclaim the lost revenue. Healthcare providers must ensure to prevent denials on the first hand and resolve them on the other.
Now that we know the challenges that prevent healthcare providers from getting their well-deserved revenue. Let's see how podiatry billing services change the outcomes and help healthcare providers in achieving an efficient revenue cycle.
Key Advantages of Podiatry Billing Services
Podiatry billing services are the perfect solution to the challenges of medical billing. Healthcare providers can benefit from such services and lead their practice to a better revenue cycle.
Following are the advantages:
Error Free Documentation and Coding
More than half of the denials are a result of errors in documentation and coding. Only accuracy in the documentation and coding can lead to error-free results. Medical billing services provide this to healthcare providers and practices.
They use advanced technology to eliminate the element of human error and incorporate systems EHR to keep a proper record of all patient data. This way they are able to deliver accuracy and consistency.
Usage of Appropriate CPT Codes
Professional billing services have a team of expert coders who are familiar with podiatry-specific coding guidelines. They ensure to follow all the changes and updates in coding guidelines. They have complete knowledge of CPT and ICD-10 codes. Apart from that, they make sure that there is complete coding compliance. As a result, healthcare providers achieve smooth operational management and maximum revenue.
Attainment of Pre-Authorization
Medical billing services offer solutions to all podiatry-related billing challenges. Prior authorization is also a challenge for healthcare providers. A podiatry medical billing company understands the importance of this step and assists the healthcare providers and practices in executing this step. The benefit is an increase in efficiency and improvement in the bottom line.
Complete Compliance
Podiatry billing services comply with all regulations, be it federal or state regulations. They are well aware of payer-specific guidelines as well. Their scope of work involves proper documentation, accurate coding, and adherence to billing and coding rules. On top of that, they conduct regular audits to detect compliance issues and prevent issues like coding errors, documentation drawbacks, and other issues.
Bottom Line
Podiatry billing services can be the best option for healthcare providers to elevate their financial performance. The solutions they offer for the medical billing challenges prove to be effective and game -changing. The results are improvement in revenue cycle management, practice management and workflow.
Unify Healthcare Services is a leading medical billing company that provides top-notch podiatry billing services. If you are in search of medical billing services in USA, then Unify Healthcare Services is the right option for you.
Get streamlined billing solutions from the medical billing specialist team of Unify and lead your practice to financial stability.
