Podiatry Billing Made Simple: Tips For Effective Revenue Cycle Management

Are you a practicing podiatrist or someone who’s just joined the field? Whatever the case, we’re sure you might have heard or come across scenarios where people might have expressed their distress when it comes to podiatry billing. Well, podiatry billing can get complex, after all, it includes comprehensive documentation, insurance verification, and dealing with claim denials. But, with a proper RCM in place, the challenges are easier to manage, and the healthcare facility operates more efficiently.

For any healthcare facility to be able to provide the best care to its patients, it’s important that the practitioners receive their compensations timely. With evolving healthcare practices and regulations, it is necessary that both the medical professionals as well as the administrative staff remain updated with the components of podiatry billing. In this blog, we shall discuss in detail the process and challenges faced in podiatry billing and learn some methods to address them.

Understanding the Podiatry Billing Process

Podiatry billing services include a few steps in order to make the billing process effective and transparent. The steps involved in the billing process are explained below:

• Patient registration and eligibility verification

The first and one of the most significant steps is to get accurate patient information and verify their insurance eligibility. This step ensures that the healthcare facility possesses all the required information for the billing process and that the insurance covers the provided services.

• Documentation and coding:

For accurate billing, the coding and documentation must be done precisely. Podiatrists use the specific CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) codes to represent the diagnosis and treatment given.

• Claim submission:

After documenting and coding, the claims are submitted to the insurers. To avoid claim rejections, submission deadlines should be met along with following the necessary guidelines.

Payment posting and denial management:

Once the payment is received from the insurer, the amount is entered into the patient’s account. The best way to deal with denials includes knowing the reason behind the denial, appealing when necessary, and taking measures to avoid future denials.

Common Challenges in Podiatry Billing

As a podiatrist, it is important to know about the challenges faced in podiatry billings. Acknowledging these challenges and working on addressing them is the only way to maintain the financial health of your healthcare facility. Below are some of the challenges faced by podiatrists during podiatry billing.

• Complex coding:

Podiatry billing involves complex podiatry coding systems, some of which include:

➤ 58550 – Cryotherapy of Skin Lesion(s)

➤ 20550 –  Injection tendon sheath/ligament

➤ 11740 – Total nail avulsion

➤  11730 – Debridement of nail(s)

Hence, practitioners must stay updated on the latest Podiatry CPT and ICD codes for accurate documentation and billing. Using incorrect codes can lead to claim rejections and delayed payments.

• Documentation challenges:

Detailed and accurate documentation plays a significant role in podiatry billing. However, practices often deal with incomplete and inconsistent documentation, which leads to claim denials, financial penalties, and legal consequences.

• Insurance payer verification:

Healthcare facilities often face delays and denials due to a lack of verification of patient insurance coverage, which further leads to delayed payment, patient dissatisfaction, and administrative distress.

• Bundling and unbundling services:

Due to the complexity of accurately categorizing treatments, bundling and unbundling services can lead to underpayments, claim denials, and overbilling.

• Audit risks:

Inadequate documentation and coding can trigger audit risks and lead to repayment demands, fines, and legal issues.

• Evolving technology and regulations:

Evolving software and electronic health record systems often lead to transitional errors. Also, the frequent updates in billing regulations further increase the risk of claim denials and penalties.

6 Tips for Efficient RCM in Podiatry Services

Below are some efficient RCM tips that can be integrated into your practice to reduce claim denials, and improve the revenue cycle management of your healthcare practice.

1. Patient management:

Efficient patient management is one of the key factors in maintaining a smooth RCM. Accurate scheduling, keeping patients’ records updated, and thorough patient intake can help reduce errors and increase patient satisfaction.

1. Coding and documentation:

Proper coding and comprehensive documentation support correct coding, which results in reduced claim denials, accurate billing, and reimbursement. Frequent training on the latest coding standards also helps optimize revenue.

1. Insurance verification and claim submissions:

Verifying patients’s insurance coverage and benefits can help prevent claim rejections due to coverage issues. Also, timely claim submissions are necessary for prompt reimbursement and reducing the risk of delayed payments.

1. Denial management:

Instantly addressing and appealing denied claims is necessary for efficient denial management. Furthermore, keeping track of denial patterns and rectifying recurring issues helps with future claim approvals while maintaining cash flow.

5. Outsourcing vs in-house billing:

Factors such as practice size, resources available, and complexity are important when considering outsourcing or in-house billing. While in-house services allow direct oversight and control, outsourcing offers expertise and efficiency that can reduce billing errors and administrative burdens, and offer quick reimbursement.

1. RCM best practices:

Some of the best revenue cycle management (RCM) practices in podiatry include training staff regularly, staying updated on changes in coding, using advanced billing software, consistent performance, and regulatory changes to ensure that revenue cycle management remains effective and efficient.

Manage RCM Effectively with Atlantic RCM

At Atlantic RCM, we have a team of in-house experts who will ensure all the claims are coded precisely, thereby reducing your administrative tasks and streamlining financial operations. Our billing services include the following:

• Patient Registration and Insurance Verification: ensuring accurate patient information and verifying insurance coverage.
• Coding and documentation review to maximize reimbursements and comply with payers’ guidelines
• Claim submission and follow-up by timely and accurate submission of claims, along with follow-ups on denied claims
• Payment posting and reconciliation through account reconciliation and efficient payment posting
• Denial management and appeals by managing denied claims and implementing effective appeals
• Patient billing and collections that are patient-friendly and transparent.

Atlantic RCM’s expert podiatry service ensures your billing processes are running smoothly, enhancing your RCM cycle, so you can now focus on providing the best care to your patients. Contact us today to know more about the services we have to offer.

Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.

Get in touch with the leading medical billing outsourcing company to learn more. Call us at (469) 501-1500 or write to us Info@atlanticrcm.com