Phases in Medical Billing Services for Podiatrists

There are several medical specializations and for each specialization, there is a certain set of rules and codes in medical billing services.

Not every medicine field has the same diagnostic and surgical procedures. Similarly, medical billing and coding guidelines and techniques are different for each specialization. Same is the case with podiatry. When a medical billing company claims for podiatry services, they work on a special dedicated plan.

First, learn what is Podiatry?

Podiatry is the branch of medicine, which is concerned with the diagnosis, treatment, and study of diseases and disorders of the foot and lower extremity. Treatments are related to regular healthcare treatments, neurological, metabolic, and other underlying issues along with injuries, wounds, and infections.

Rules Regarding Medical Billing Services for Podiatrists

The Center of Medicare and Medicaid Services (CMS) has defined rules and procedure for each discipline of medicine. There are clear instructions of what should be covered under an insurance plan for podiatrists. New medical billing outsourcing companies can take notes from their official website.

Insurance Don’t Pay for Non-Medically Necessary Services

Under CMS rules, insurance companies will only pay for medically necessary foot care services.

A regular foot care service falls into the following categories.

  • Additional
  • Mandatory
  • Supplemental
  • Optional supplemental

What Exclusions Are Involved in Podiatry Medical Billing?

There are certain cases in which fighting with insurance companies for reimbursement is straightaway lost war. There is no point in sending claims for the following cases.

Straight away rejection cases include:

  • Initial care service
  • Existence of metabolic, neurologic, or other peripheral vascular diseases
  • Mycotic nails
  • When a patient is already receiving primary healthcare
  • Dislocation of ankle joint
  • Subluxation of structures within feet
  • When a patient wears orthotic shoes
  • When a diabetic patient wears special shoes

To higher the acceptance rate of medical claims, medical billing services should precisely state the name of the podiatrist, who diagnosed the disease. Moreover, the severity of the condition should be reported not just the diagnostic procedure.

New medical billers and coders often get lost in the maze of instructions and guidelines. Medical billing for podiatry indeed requires a great level of accuracy as insurance companies don’t pay for these services very easily.

However, with little care, necessary paperwork,  just like we do, there will be no problem in the claim submission process. We, P3 Healthcare Solutions, Ontario, CA have carefully devised medical billing methods for different specialties and offer specialty-specific services to physicians.

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Healthcare Demands Skilled Workforce besides Modern Setups

We pass through time in need of smart additions in healthcare to manage the developing requirements. Yes, the environment goes from quantity-driven to quality-driven giving rise to the need for a dynamic workforce. Technology being the major driving factor affects the industry as we speak. The difference between demand and supply creates a vacuum, and to fill up that space, we must look for people with matching skills.

What kind of workforce are we talking about? Whether they are nurses, physicians, HIT consultants, medical billing services, RCM, medical billing and coding consultants, data scientists, case organizers, credentialing and enrollment specialists, hospitals both large and small face many obstacles to find the right people for the right roles.

P3 Healthcare Solutions, Ontario, CA follows an idea to seek excellence in everything it does. It is not a one-time heroism but a constant struggle to maintain a steady workflow.

Is Your Healthcare Practice Ready for Workforce Challenges?

When we say challenges, we are not kidding. The threat is very real.

We require more technology experts who know their way around tools, websites, rules, reporting, and compliance standards. CMS comes up with new and updated rules under which healthcare practices may be incentivized or penalized.

Furthermore, MIPS 2019 is the current face of value-based care. To select appropriate measures and report them to CMS, the system demands skilled IT professionals.

Not only that, but the growing aging population is a persisting problem, we have to be ready for. It directly relates to the need for more doctors and nurses. Cybersecurity, on the other hand, isn’t less of a concern in an era of software and the Internet. As healthcare warriors, we must position ourselves and learn modern ways to tackle intruders and viruses.

What Does The 2019 HIMSS Survey Suggest?

The latest 2019 HIMSS U.S. Leadership and Workforce Survey covered 232 health information and technology experts from acute and ambulatory providers across the country. The purpose was to know about the hurdles in their way and the organizational steps they want to take to answer them.

The report also confirms the diverse nature of opinions of hospitals and non-acute facilities when it comes to health information technology, medical billing services and workers in general.

For instance, inpatient setups view the hiring of C-suite executives as a priority. They can steer strategic goals in a meaningful direction.

Another comparison between hospitals and practices monitors the role of rank-and-file employees. The opportunity level differs from one another – the larger inpatient sites offer extensive work opportunities whereas non-acute physicians have a static workforce requirement, according to HIMSS. A staffing strategy hugely depends on IT factors among others.

Healthcare vs. Current Challenges

Admittedly, the challenges at hand pose a threat equal to a disaster waiting to happen. We can only deal with them if we have the right workforce. We can make use of the skilled workforce under –

  • Cybersecurity, privacy, and data security
  • Health information and tech to improve patient-centered outcomes
  • Clinical engagement and clinical data management
  • Care coordination
  • Process improvement, workflow, and administration
  • Business intelligence
  • Leadership
  • Health information exchange and promoting interoperability (PI)

Staffing poses as big a challenge to providers as the implementation of a new law to federal agencies. They feel the negative impacts of it day after day.

Increase in Labor Force Spend

Expect to listen to ‘You’re Hired’ in the upcoming times. It will increase the spending on labor force required to run a hospital. AI, digital health, the use of CEHRT, Telehealth and medical billing outsourcing can raise your chances to cut down costs.

Your passion may be bigger than your job, but with the growing population and quality metrics taking over, it is easy to predict skilled workforce to be one of the crucial aspects of healthcare in the future. To be able to run a facility to full effect, the inevitable support of HIT consultants and medical billing company matter now more than ever. To get the latest medical billing and coding advice, follow us on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions

Do you face any challenges in terms of practice administration, revenue generation and compliance?

One Day in the Life of a Medical Biller

Working in a medical billing company is not at all easy. Medical billing service providers go through a roller coaster of emotions every day. Gathering bulk of data from each clinician and carefully creating medical claims requires lots of efforts.

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Let’s take you through the journey of how we manage to do it all, have a look!

When medical practices hire P3 Healthcare Solutions for a complete medical billing solution, we make sure to grasp on each detail that they offer to maximize revenue as per the demands.

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Medical billing and coding agents don’t really have much time to spend on other activities.  Whenever they’re spearing some moments with colleagues, an alarm clock inside their heads gets them back to work.

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One thing is certain; medical billers and coders are so used to tough times that nothing surprises them anymore. Not even denied medical claims.

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Insurance companies have strict rules; meeting their standards is almost like climbing up the K2 Mountain.

You guys can’t even imagine the feeling when medical billing services meet up their target and submit medical claims to the payers.

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The billers and coders usually go through a session of internal crying, upon receiving the news of the denied medical claim.

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After the tiring work hours, when we listen to the good news that insurance companies have agreed to pay the full reimbursement.

We go through a phase of shock, as getting money from a private payer is certainly not a piece of cake.

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And, then, we feel like clapping and dancing to our favorite beats.

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Insurance companies when pay the required amount to clinicians, they, upon receiving the money become extremely excited.

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As a professional medical billing company, P3Care also get satisfaction by making our clients satisfied.

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Jokes aside, medical billing services work tirelessly; and, we find our happiness in serving the healthcare industry by sharing the burden of physicians.

4 Tips to Improve Patients’ Payments via P3Care, Ontario, CA

Medical billing companies have the responsibility to make physicians’ survival easy by collecting reimbursements. Insurance plans are of many types, and in case of private healthcare plan; patients are required to pay deductibles from their pockets.

The healthcare expenses in the U.S have already reached a limit; where even a middle-class patient finds it difficult to clear off his bills. Therefore, getting deductibles and co-payments from patients prove to be a hectic job for medical billing services.

Apart from the strict rules of insurance companies, medical billing companies have a hard time collecting patients payments. Then, how can they ease their burden and reduce accounts receivable (AR)?

It might seem like an impossible job, but via 4 simple tricks that P3Care has learned over the years, medical billers can achieve success in this regards.

  1. Medical Billing Companies Should Allow Multi Channels Payment Methods

Suppose you and your friend have to pay some bills, it is not necessary that you both will pay through the same method. Maybe you like paying cash and your friend might like to pay via credit card.

According to research, customers make payments based on the fact that what is convenient for them. Same is the case with patients. When there are multiple payment methods, patients can opt for the most suitable method. Medical billing companies should encourage clinicians to have a flexible payment method. Otherwise, hospitals would be missing out some major revenue.

The Omni channel approach of payment model doesn’t restrict patients with minimum access to choices. It will also have a positive impact on the patients’ satisfaction level.

  1. Adopt Automated Payment Method

Automated payment refers to paying bills on a predetermined date. This payment method ensures secure and confirmed payment by the patient. As the patient already knows about the scheduled payment, medical billing companies thereby, need lesser staff for payment collection.

Generally, via this method, patients make payments on time, especially the ones with high deductibles. Moreover, the billing staff can reduce unnecessary expenditure. For Instance, on paper files.  Automated bills also help to reduce the efforts for follow-up services.  The front desk of medical billing companies doesn’t have to go after each patient for payment. They only have to decide upon a specific date, and the process goes by easily, other than in exceptional cases.

P3 Healthcare Solutions being among the best medical billing companies in Ontario, CA recommends that medical billers should inform about the total payment while deciding upon the payment plan to the patient, rather than asking for a fee each month.

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  1. Educate Patients about their Payment Responsibilities

Medical billing services should be clear about one thing; you can’t expect patients to pay deductible and co-payments at once, particularly, if they’re in significant numbers. Nobody likes such surprises. Therefore, a better approach is to educate patients in the early stages of their financial responsibilities.

It is also proven from research that around 91% of patients like to know the complete payment model prior to the visit. Clinicians in association with the medical billing service should map out every payment detail in front of the patients. Only this way, physicians will manage to increase revenue for themselves.

It also brings forward a good reputation of the physicians and makes patients trust more on the medical practice.

  1. Ensure HIPAA-Compliance in Payment Model

Patients’ data security is everything. However, healthcare data is always at risk. We have seen many scenarios where data breaches lead to huge revenue losses. While creating medical claims and collecting payments from patients, medical billing staff works with sensitive information, be it, credit card information and healthcare records.

Taking exclusive measures to protect the misuse of data requires the allocation of dedicated resources, which some companies might not be interested in. However, this step can’t be neglected. Besides streamlining other billing operations, patients’ data security also adds to revenue increment.

Moreover, designing a comprehensive security plan as per the Payment Card Industry (PCI) standards don’t necessarily require a huge investment.

P3Care is one of the renowned names in the medical billing world.  We have worked for several years in this industry and increased revenue for many clients. By implementing above-mentioned tactics, we have managed to generate fruitful results. Hopefully, it’ll result in the best possible way for minnows of the billing industry.

In What Ways Medical Practices Can Take Risks to Increase Revenue

Everybody agrees that healthcare professionals, no matter in what capacity they serve, require every bit of applause. Working in hospitals is indeed a hectic job, and clinicians work tirelessly from day to night.

When it became difficult for physicians to meet up with ever-changing scenarios, medical billing companies came to their rescue.

Now, insurance companies have strict rules and regulations, and physicians get reimbursements only when they meet the standards. Also, with the already complex U.S healthcare system and value-based incentive programs as MIPS, physicians tend to put greater efforts for their survival. It also put pressure over the medical billing services, as they could not afford to perform below average.

Besides, the focus on value-driven healthcare services has increased. Patients’ engagement level and integrated healthcare infrastructure have also gained more importance than before. Thus, medical practices ought to implement strategies that benefit them in the long run.

According to a survey report of Healthcare Financial Management Association (HFMA), more than 7 medical facilities in a group of 10, aim to take risk via

  • New commercial payers
  • Medicare advantages
  • Medicare contracts

One thing is interesting to note that many healthcare leaders support the idea of a revolutionary healthcare system that benefits both, patients and physicians.

Provider-Sponsored Healthcare Plans (PSHP) is gaining much attention even from medical billing companies as patients get insurance plan owned by a hospital or physician. 25% of the medical practices are already going to be part of the PSHP system, and 19% of hospitals want to launch their own healthcare insurance plan in the upcoming years.

Alongside this, Medicare and private payers are also increasing their range of insurance benefits.

What Benefits will Physicians Get?

If medical practices take chances to go for new payment models, both payers and physicians will be equally benefitted. Physicians will be able to implement accurate value-based practices while being closely in touch with the payers. The communication gap will be reduced, and the medical billing companies will reduce the rate of denied medical claims.

The Use of Healthcare Technology

By taking bold steps to increase reimbursements and efficiently run revenue cycle management, physicians will be able to use the latest healthcare technology successfully.

Hospitals will manage to spend efficiently upon the technological infrastructure to increase engagement between physicians, patients, and payers. Surprisingly, many physicians are ready to spend money on new technology avenues.

What are the hurdles that might come?

Even in 2019, there is not much demand for drastic risks in the healthcare industry. Although, many physicians like the idea to try something new. Still, they are comfortable with the Fee-for-Service (FFS) payment model.

What Should Physicians Do?

You can always take risks whenever you want.  On the contrary, you can also benefit yourself from the existing payment model and generate revenue by focusing on the betterment of the following parameters.

  • Engagement rate
  • Standardized clinical procedures
  • Cost-effectiveness

If you’re struggling in managing accounts receivable (AR), taking risks may seem like an appropriate option, but the transition process is also tiring. You can’t expect to achieve everything within a little time. The best approach is to keep improving healthcare strategies gradually and consult a professional medical billing company that creates medical claims with up-to-date knowledge. Like, P3 Healthcare Solutions- A professional medical billing company in Ontario, CA that has years of experience in the billing field and helps in generating revenue for its clients.

What are your thoughts? Let us know if you’re willing to take risks regarding revenue generation?

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