Would you like to optimize your reimbursements through effective podiatry billing? How can a billing system improve reimbursement? Yes, it is possible when a hospital incorporates accurate coding and efficient billing in their daily practice. Podiatry-specific billing is a system in which professional billers will only manage bills, claims, and codes related to billing.
Usually, podiatry practices face many challenges such as claim denials, outdated codes, and insurance verification errors. All these errors can be solved by a specialized and professional medical billing company like SysMD. In this blog post, we will provide a podiatry medical billing guide for your healthcare organization. You will know about codes, challenges, solutions, and related stuff.
CPT Codes in Medical Billing for Podiatry
Current Procedure Terminology (CPT) Codes are widely used in podiatric setups in the USA. It is a complete list of specific numbers and alphabets that show specific diagnoses and treatment plans.
Insurance and payer companies accept only those claims that follow medical coding accuracy. CPT code updates come monthly or annually, and hospitals follow these updates in their podiatry medical billing systems.
Common foot care billing codes are as follows:
| CPT Code | Description |
|---|---|
| 99202–99205 | Initial office visits for new patients, determined by case complexity |
| 11719–11732 | Nail Care Services |
| 11055–11057 | Callus and Skin Care Services |
| 20550–20551 | Injections and Nerve Blocks |
| 11042–11047 | Surgical Debridement |
Common Podiatry Billing Challenges & How to Overcome Them
Medical Billing for Podiatry can be challenging if your system is outdated, or staff is uneducated. You have no chance to make mistakes in billing practices because it affects your financial improvement. Further, it also put insurance companies and patients into trouble.
Some repetitive billing mistakes in podiatry that lower reimbursement rates are listed below:
Denial management
Denial management is a big deal in podiatric clinics because the revenue cycle depends on it. Podiatry claims are often denied because of incomplete information, incorrect coding, and improper documentation. Any single reason can be a cause to reject a claim.
You can approve podiatric claims by putting complete information about the patient, accurate and updated codes, and complete documentation. Further, review your claim before final submission and submit it before deadlines.
Insurance Verification Errors
When insurance companies cannot verify the patient data with the hospital data, they reject the bills. Mostly, payers need prior authorization for all claims, especially podiatry billing. When hospital staff do not follow eligibility verifications, payer companies will not pay for these patients. Thus, it puts a financial burden on the podiatry medical billing department.
You can decrease insurance verification errors by following the podiatry billing guidelines of insurance companies. Also, mention the accurate medical necessity with the procedure and lab tests so that they can reimburse accordingly.
Billing Software vs. Manual Processes
Now, advanced technology has reached every department of life including hospitals. Still, many small podiatry clinics are operating on manual billing systems. They do not have advanced billing software and trained staff to handle billing equipment. It leads to many manuals and human errors such as claim denials, coding mistakes, and revenue fall.
You should incorporate advanced billing software such as claim processing tools, code addition tools, and insurance verification tools. Podiatry billing software helps minimize administrative workload and lowers the risk of billing mistakes. Thus, your revenue cycle will improve.
The Role of Podiatry Billing Software in Revenue Optimization
Billing software has made podiatry medical billing accurate and fast. Every step of billing has a different tool. These tools are based on AI algorithms that streamline your billing system and enhance revenue optimization. Thus, you can improve cash flow with the help of automated podiatry billing software.
Let us check how workflow automation optimizes revenues:
Quick Claim Processing
Advanced podiatry billing tools have algorithms that can detect the errors in the claims before final submission. You can use different tools to recheck the complete patient information. In this way, you can fill in the missing data and attach the incomplete documents on time. Thus, claim processing has become easy and fast with the help of these billing tools.
Rapid Eligibility Verification
Mostly, insurance companies reject claims because of eligibility issues. Verifying patient eligibility is often a lengthy and time-consuming process. That is why, many billers skip this crucial step and payers reject the claims because of non-verification.
Advanced billing software can check the eligibility of the patient according to the updated guidelines of insurance companies.
Accurate Coding Compliance
Coding is a complex procedure in podiatry medical billing. A lot of complex numbers and digits for specific conditions. Sometimes, the coder puts wrong and outdated codes in the claims because of a heavy workload. Billing tools have made the coding simple and fast. Now, there are built-in CPT and ICD-10 codes that you can put in the claims automatically according to the patient’s condition.
Here is a detailed comparison of some advanced billing software:
| Features | SysMD | AdvancedMD | DrChrono |
|---|---|---|---|
| Best For | Small to mid-sized podiatry practices | Large or multi-location practices | Mobile-friendly small to mid-practices |
| Billing Features | Podiatry-specific CPT code support, clean claim submission, denial management | Automated claims processing, RCM, reporting | Integrated billing, claims, ERA, and eligibility checks |
| EHR Integration | Yes, with podiatry-specific templates | Full EHR integration | Fully integrated EHR with iOS access |
Outsource Podiatry Medical Billing: Is It Right for Your Practice?
Whenever you hear this advice from somewhere “outsource podiatry medical billing!”. You must think that will be effective or just a waste of money? A third party can handle your billing system effectively.
When should you consider outsourcing?
When your revenue cycle is continuously going into a loss, you should get help from professionals. When your staff is unable to put accurately updated codes or when you are facing claim denials continuously, you should hire billing specialists.
How Outsourcing Podiatry Medical Billing Improve Efficiency?
Let us see how hiring billing service providers can improve the efficiency of podiatry medical billing:
Years of Experience
Professional billing firms like SysMD have years of experience in handling different billing departments. They play their roles in increasing revenues and conversions in the profit of a hospital.
Use of Advanced Technology
Expert billers use advanced technology in routine billing tasks. They use specialized podiatry billing tools for claim submission and code incorporation.
Reduce Administrative Burden
Workload increases on medical staff when they treat patients as well as handle billing tasks. Outsourcing third-party billing can reduce administrative burden and manual errors, ultimately boosting the financial health in podiatry by streamlining revenue processes and improving accuracy.
Case Study
Let us see how can a Podiatry Medical Billing Business Increase Reimbursements by 30% by taking help from SysMD.
Problem
A podiatry clinic was struggling with low reimbursements and claim denials.
Solution
When they would partnered with SysMD to streamline their revenue cycle. We implement accurate podiatry CPT coding, automated claim scrubbing, and integrated EHR billing systems.
Result
The clinic would reduce its denial rate from 18% to 5% and shortened reimbursement times from 42 to 22 days. As a result, the clinic saw a 30% increase in reimbursements within just three months.
Choose SysMD for Professional Podiatry Billing Services
Want to increase reimbursement rates? Then, Choose SysMD and get professional and reliable billing services. We care about your investment inpatient treatment and procedures. That is why, we are dedicated to improving your podiatry medical billing system
Conclusion
Efficient podiatry medical billing is key to maximizing reimbursements and minimizing claim denials. You can streamline operations and boost revenue by outsourcing to experts like SysMD. Let professionals handle billing while you focus on delivering quality foot care.