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If we look closely at the current healthcare landscape, the most crucial aspect for medical specialties including podiatry is a streamlined and successful billing process. However, the reality is quite the opposite. Podiatry medical billing and coding pose unique challenges due to the specialized nature of podiatry services. There are various intricacies involved in coding and billing for this field.
The role of podiatrists is to concentrate on diagnosing, treating, and preventing foot, ankle, and lower extremity conditions. It is necessary to the partner with an effective medical billing software for podiatry practices. This helps to optimize the revenue cycle. Relying on a reliable medical billing software like Unify Medicraft is a practical strategy to maximize revenue and minimize claim denials in podiatry practices.
Podiatry medical billing is certainly a complex but crucial aspect of running a successful podiatry practice. The process involves submitting accurate claims, managing reimbursements, and addressing the intricacies of various policies. However, there are several common issues that can arise during the billing process. These issues contribute to the financial loss and administrative burden.
Let’s get into the most common challenges in podiatry medical billing and emphasize the importance of getting a medical billing software such as Unify Medicraft to mitigate these challenges effectively.
Common Challenges of Podiatry Medical Billing
Hereunder are the common factors that contribute to the complexity of podiatry billing:
Specific coding requirements
The most complex factor is that Podiatry has its own set of specific coding requirements. The work of podiatrists is to diagnose and treat a wide range of foot and ankle conditions. This includes fractures, sprains, infections, deformities, sports injuries, diabetic foot complications, and many others. They do various procedures and treatments that are different from other medical specialties. It includes:
- Achilles tendon repairs, Bunionectomies, ankle arthroscopy, and joint fusions.
- Other non-surgical treatments such as orthotics, physical therapy, wound care, and pain management.
- Proper Assessment of the biomechanics of the lower extremities.
- Detailed management of foot complications related to diabetes.
- Treatment of Foot and ankle sports injuries.
- Undivided care for foot and ankle conditions connected to systemic diseases. It includes rheumatoid arthritis or vascular disorders.
- Preventive care to minimize the occurrence of foot problems. This is majorly for the elderly and individuals with chronic conditions.
To ensure compliance and accurate reimbursement it is extremely important to bill all these procedures and treatments correctly.
Complex rules and regulations for billing
There are various rules and regulations that must be considered while carrying out the medical billing and coding procedure. These regulations are related to coding guidelines, documentation requirements, claim submission, and reimbursement processes. To keep up with these ever-evolving rules and regulations demands ongoing education, awareness, and training to avoid coding errors and billing denials.
Compliance with coding guidelines
It is mandatory that Podiatry coders follow the coding guidelines set by organizations such as the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). It can be a challenging practice to stay up to date with coding guidelines and ensure compliance, especially with regular updates and changes.
Medical coders must be familiar with the podiatry-specific CPT and ICD-10 codes for the podiatry as well as modifier use. If necessary, it is possible to use multiple modifiers with a single procedure code. Remember that not all modifiers are applicable to every category of CPT codes. There are specific modifiers that are exclusive to specific categories, while others are not compatible with certain modifiers.
Challenges in Documentation
For proper coding and billing in podiatry, ensuring accurate and comprehensive documentation is mandatory. It is a must that podiatrists provide detailed and specific documentation of patient encounters, procedures performed, diagnoses, and medical necessity. If there is any sort of incomplete or inadequate documentation, it can lead to claim denials, delays in reimbursement, and potential compliance issues. While documenting, it is essential to ensure that all the information is relevant. It includes the patient’s chief complaint, history of present illness, examination findings, treatment plan, and any other necessary details.
Another problem that arises is that many of the services provided by a podiatrist may not be reimbursable. Therefore, to determine the medical necessity and to validate the coverage is critical. This poses a challenge on getting reimbursed optimally. For instance, in case of billing for a nail debridement, it is essential to furnish supporting documentation which demonstrates the necessity of performing the debridement procedure.
How can a medical billing software make your life easier as a podiatrist
Insurance Eligibility Checks
One of the most time-consuming processes for your administrative staff is tracking down insurance eligibility information for your patients. Instead of spending time with insurance providers, you can have a medical billing software for podiatry practices that automatically checks insurance coverage statuses for you. This not only makes billing easier but also streamlines the check-in process. Whether you are using an iPad or a desktop, your system will quickly identify insurance eligibility, and you can carry out the process of appointment.
Creating Billing Profiles
Every healthcare provider, especially podiatrists come across certain procedures. The medical billing codes that you commonly use, those the medical billing platform should allow you for create billing profiles. They are a powerful time-saving tool that will automatically populate the billing information for specific types of encounters that you have come across.
For instance, if your podiatry practice frequently sees patients related to wart removal, the smart idea would be to set up a billing profile with the codes that are needed for the treatment. On the top of that, you can get rid of repetitive data entry. In the long run, you will also find fewer errors in your billing because you are using a medical billing software.
Better Option for RCM Services
Although you might be capable of handling medical billing internally right now, in the future, there might come a time where your patient volume is outpacing your staff’s bandwidth. Before your practice reaches that point, you should consider getting medical billing software for your podiatry practice.
Medical billing software like Unify Medicraft is uniquely qualified to handle your revenue processes and will surely improve the efficiency of your billing. Ideally, there will be complete transparency of how the entire coding & billing including the entire process is carried out smoothly.
In the beginning, when you start the practice, some solo practitioners may not have growth in mind which is perfectly reasonable. Later when you anticipate expansion for your podiatry practice, an option for getting a medical billing software for podiatry practice is useful to keep everything on track.
Conclusion
As a podiatrist, you should not let your medical billing tasks prevent you from claiming the revenue entitled to you in a timely manner. Podiatry coding and billing can be complex, but with the right software, it doesn’t have to be.
To get the right medical billing software for your podiatry practice is difficult. Many podiatrists are solely running the practices, so their time is incredibly valuable. With Unify Medicraft as your medical billing software for podiatrists, you will experience a better management and have a better control over the revenue of your healthcare practice.