Blogs | Podiatry Billing and Coding

Rules for Successful Delegation in Your Podiatry Practice

Whether your podiatry practice is large or small, it will benefit from successful delegation to competent staff. All too often, delegation is something that is put off when, in reality, it should be the first thing to consider when you are looking at efficient office and time management.
There are many reasons why podiatrists procrastinate when it comes to the delegation of tasks to their office staff.
Let’s take a look at why delegating tasks and responsibilities may be the only thing keeping you from running a successful podiatry practice.

5 Lies about Successful Delegation You May Believe

Lie: It’s easier for me to do it than to train someone else.

Truth: This may be true if that specific task doesn’t need to be done on a regular basis. However, if it is something that needs to be done more than 2 times a year, consider the training time spent as an investment.

2. Lie: No one can do this job as well as I can.

Truth: If you invest in training time with your staff, they will be able to do the task efficiently and effectively. If not, perhaps you are not choosing the right staff member for that particular task.

3.Lie: I don’t want to deal with pessimistic responses about the tasks being delegated.

Truth: A staff member performs better when they are offered responsibilities and when they feel like they are a valued member of the team as opposed to someone who can’t be trusted for specific tasks.

4.Lie: It’s faster for me to do it than to train someone else.

Truth: In the long run this doesn’t ring true. You will not only save time by not having to do the task on a regular basis but also save stress from not having to worry about that task anymore.

5.Lie: Delegation doesn’t work for me

Truth: When done correctly, delegation works for everyone. Face it: There is only so much value you can add to your practice without enlisting the help of others. You will quickly burn out if you insist on doing it all yourself.

How to Delegate Successfully

The first step to successful delegation is to determine what tasks can be delegated most logically. Things to look for would be…

Are you comfortable with someone else taking on responsibility for this particular task?

It’s important to remember that proper delegation is more than just assigning work to someone else. It is not only letting go of a task. It also involves transferring the decision-making responsibilities along with the task.

What is the time investment involved with passing this task on to someone else?

When considering what tasks can be passed on, we must also consider the time investment. If there are other tasks that your office staff can do with less time commitment for training, perhaps those tasks would be a better fit for the time being

Are there tasks that can be coupled with something that a member of your staff is already doing?

For instance, if your staff is already trained in the paperwork and ordering of wound care supplies, perhaps that same team member can be trained to take an orthotic foot impression or instruct a patient about wound care uses.

Is there a task that brings out a particular strength of someone on your staff?

Perhaps someone on your staff is well versed in social media; that person may be a good fit for weekly posts and keeping your profiles updated.

Is there a task that can be outsourced to a capable third-party company?

Successful delegation may need to go beyond the 4 walls of your office. If you find that billing is a constant stressor, consider outsourcing it to a company that specializes in podiatry billing.

Common Mistakes to Avoid When Delegating Tasks to Others

In order to successfully delegate tasks, you must have a realistic idea of what to expect. By being informed, you will be able to avoid some of the common short-term pitfalls that come with delegating tasks.

Expect mistakes.
Making mistakes and learning how to correct them is an invaluable part of the learning process. Allow the team member whom you have chosen for the task a margin for error. With time and practice, those mistakes will become far less frequent.
Don’t over-delegate.
Expecting too much from one person is a quick way to create employee burnout. Make sure that you are openly communicating with your team about your expectations and allow them to express when and why they are overwhelmed.
Manage, but don’t micromanage.
Once you’ve delegated, trained, and set up a schedule for touching base, step away from the project. To succeed (and to help your practice succeed), you have to let go. However, stick to your schedule for checking in to see if there is anything that needs attention. If it does, allow the team member responsible for the task to give it the required attention.
Clearly communicate the desired outcome of the accomplished task.
Be specific with your tasks, including the reason a task needs to be done, the deadline, and the expected results. Employees need a clear understanding of your desired accomplishment with all delegated tasks. Even if it seems self-evident, take the time to express your wishes plainly.
Say thank you.
A little praise can go a long way. When you feel as if your office staff has caught on quickly and given their best efforts, tell them! Employees feel valued when they get feedback, especially positive feedback.

Conclusion
There is no such thing as a single-handed success. The fact is that new, revenue-generated opportunities exist in your practice when you are willing to commit to making moderate changes.
Take your practice to the next level simply by removing basic time-consuming tasks from your plate and successfully delegating them to your office staff. Follow the rules laid out above and put that “do-it-yourself syndrome” to rest for good.

HIPPOCRATIC SOLUTIONS ANNOUNCES PARTNERSHIP WITH IREMEDY, SIMPLIFYING WOUND CARE PRESCRIPTIONS

Hippocratic Solutions, an outsourced podiatry billing firm, has announced a partnership with iRemedy. iRemedy is the leading e-commerce medical supplies provider. This partnership will enable podiatrists just like you to prescribe, dispense, and bill for advanced wound care supplies through their DME license.

Along with outsourced podiatry billing services, Hippocratic Solutions’ clients will now have instant access to iRemedy’s online platform with the ability to submit and manage wound care prescriptions for their patients with chronic wounds.

Billing for wound care prescriptions will be made easy, as podiatrists will be able to file and bill the prescriptions directly through iRemedy. Then iRemedy will audit the prescription for the podiatrist and handle insurance preauthorization and any insurance denials.

BENEFITS OF THE PARTNERSHIP
“Integrating iRemedy with Hippocratic Solutions is a real breakthrough that is going to take our Advanced Wound Care Program to the next level,” said Tony Paquin, CEO of iRemedy Healthcare.

iRemedy has developed an innovative solution to one of health care’s oldest and most expensive problems: the spiraling cost of medical supplies.

By using a sophisticated process of EMR (electronic medical records) and supply usage, they are able to more accurately predict what supplies are needed within your podiatry practice and dramatically cut costs.

“Most podiatrists don’t think they can dispense and profit from wound care supplies through their license, but this just isn’t true,” said Peter Koukounas, CEO of Hippocratic Solutions. “By partnering with iRemedy, we’re helping podiatrists earn greater profits while drastically improving patient outcomes.”

WHY SHOULD A PODIATRIST DISPENSE WOUND PRODUCTS?
The most obvious reason is that it will lead to better outcomes, such as subsequent referrals. When a DPM writes a prescription for dressings and sends the patient to a pharmacy or arranges for home delivery without proper instruction, there is often confusion and poor follow-through.

This partnership between Hippocratic Solutions and iRemedy allows the podiatrist to focus on the patient. Our goal is to eliminate the headache of paperwork that follows wound care prescriptions, thus making it a more convenient option for all involved.

SIMPLICITY AND CONVENIENCE
Once the product dispensing process is in place, the benefits will be obvious. Patients will have the knowledge and supplies to properly handle their wound care from the comfort of their own home. Simply put, this is much more convenient for the patient.

There are no trips to the pharmacy and no delays. Podiatrists will leave their patients with a clear understanding of what they need to do. Patients are more likely to be adherent when they have all the right supplies shipped directly to their home.

Those interested in the advanced wound care services through Hippocratic Solutions can contact the company by phone at (866) 305-3911 or visit www.hippocraticsolutions.com/wound-care-kits/.

WHY YOU NEED OUTSOURCED PODIATRY BILLING

When it comes to podiatry billing, there are only two options: hire an in-house team, or outsource the job to a third-party company. Which road will you take? In this blog, Hippocratic Solutions will discuss the benefits of outsourcing your podiatry billing to a professional medical billing company. If you choose the right company for the job, outsourcing has the potential to save you money, free up time, and leave you with less to worry about on a day-to-day basis as the owner or manager of a podiatry clinic.

IT’S LESS EXPENSIVE.
Depending on the size and current state of your podiatry practice, outsourcing your medical billing could be a financially responsible decision. If you’re a brand new practice, you’ll have to spend thousands on equipment and employees to create your own in-house billing department. This can be expensive in terms of money and time — and if you experience a high turnover rate with billing employees, your in-house billing experiment could burn a hole in your wallet.

With outsourced podiatry billing, you’ll never have to worry about training or retaining employees. Highly seasoned medical billing professionals will use the most up-to-date processes and software to collect on balances, process claims, and manage your entire billing database for you. No need to pay for employee benefits or deal with hiring — outsourced medical billing services take care all your billing needs for you.

IT’S TRANSPARENT.
If you need comprehensive performance reports from your in-house billing department, you might have to do some teaching or micromanaging to get them. This just isn’t the case when you use a podiatry billing company. To be successful and sustainable, third-party billing companies must be transparent — which is why they often release monthly performance reports or reports by request. Medical billing companies often find more insights into your billing operations than an in-house team could — no nagging or micromanaging required.

IT’S CONSISTENT.
Outsourced podiatry medical billing companies are expected to perform a specific set of duties, and to do them well all the time. For example, they’ll need to appeal denials with a certain level of success. No matter what specialized billing company you choose, they should be able to do the job well all the time.

IT’S HANDS-OFF.
Some might argue that having control is better than not having control. However, when it comes to medical billing, it might be worth it to leave it to someone else. You have more than enough to worry about when running a podiatry clinic — your patients, your finances, your podiatrists, and your medical equipment, among other things. Do you really want to worry about a billing department and claims processing? Outsourcing highly technical jobs to highly trained experts frees up more time and money for you to worry about what matters the most to you and your practice — and that might be the most valuable asset for your practice’s success in the short- and long-term.

CHOOSE THE PODIATRY BILLING PROFESSIONALS
Hippocratic Solutions is your preferred partner for outsourced podiatry billing, giving you less legwork and more money to run your clinic the right way. Using time-saving podiatry billing software, Hippocratic Solutions allows you to grow your practice by putting your billing in good hands. Don’t wait — contact us to speak with an expert today.

UNDERSTANDING THE PODIATRY BILLING PROCESS

As your podiatry practice grows, you may start to wonder about outsourcing your billing to a third party. It’s easy to feel overwhelmed by the process of outsourced billing and the options available to you. We should not forget that the delivery of health care is also a part of the industry that needs our attention. From a business standpoint, having a smooth and efficiently run practice allows you to concentrate on patient care.

Let’s walk through that process step by step. That way, you’ll have a better understanding of the podiatry billing process and feel more confident in the option you choose.

We’ll look at the most common insurance types, coding, and whether or not outsourced billing is right for your practice.

4 TYPES OF INSURANCE FOR PODIATRY BILLING
There are 4 major types of insurance carriers that are likely to insure your patients.

1) The HMO: Health Maintenance Organization
An HMO is a very cost-effective health care plan. People who join an HMO pay a fixed annual fee for comprehensive health care.

These plans may include preventative care. Patients who are insured by HMOs are restricted to use only the individual plan’s network of providers. Many of the services covered by an HMO require preapproval.

2) The PPO: Preferred Provider Organization
Like an HMO, a PPO has a preferred network of providers. Patients can, however, choose to go to a provider outside of their network. When they elect to do so, they must pay the difference between the network doctor’s fee and the cost of the doctor not covered by the plan.

A PPO costs the patient and their employers a bit more than an HMO plan.

3) The POS: Point of Service Plans
The final type of non-Medicare insurance carrier is a POS plan. This plan is generally described as a hybrid of the HMO and PPO type of plan.

Members of a POS plan can use out-of-network doctors like those with PPOs can. However, when they do, they have reduced levels of benefits. For example, in utilizing a plan’s network doctor, the patient may have 100% coverage; going out of network, they may only have 70% coverage.

4) Medicare or Medicaid: Government Funded
The final and most common types of insurance carriers that you will likely deal with are the Medicare/Medicaid plans. Medicare and Medicaid are federal and state-funded programs.

What’s the Difference?
Medicare insures the elderly and those who are disabled, while Medicaid insures those whose income falls below a certain threshold.

Unlike the HMO or POS plans, patients do not need primary care referrals to see podiatrists. The Medicare fee schedule is published annually, and Medicare pays 80% of the allowable fee. Either the patient or the patient’s secondary carrier is responsible for the remaining 20%.

Medicaid also has a set fee schedule. The Medicaid fee paid is generally lower than Medicare, and billing the patient any balances is prohibited.

INSURANCE COMPANY POLICIES IN PODIATRY BILLING
All health care plans have an established fee schedule that you should obtain at the beginning of each fiscal year. Simply put, the fee schedule is a listing of accepted fees and allowances for specific medical procedures. It usually represents the maximum amount that the program will pay for the specified procedure.

Members who are part of a managed care plan often have what’s known as a co-payment. This is a small fee the patient must pay at the time of service to a physician.

Co-payments are designed to discourage overutilization of health care services, as those $10 or $20 payments per visit add up for patients.

Coinsurance is the amount of the fee in percentages that a carrier pays. This leaves the patient or a patient’s secondary insurance carrier with the balance. Many patients will subscribe to a secondary insurance plan to help fund this balance. If they don’t have a secondary plan, the patient is liable for that balance.

Many plans (including Medicare) have an annual amount of money that a patient must pay out of pocket before their insurance benefits are initiated. This is known as a deductible. At the beginning of each year, it’s important to educate your patients about their deductible. Attempting to collect payments in a timely manner will help in avoiding a cash-flow crunch.

Following the service, a patient receives a comprehensive document. This is known as an Explanation of Benefits, or EOB. The EOB discloses what fees were allowed, what the physician was paid for that service, and what the patient’s financial obligation is.

WHAT YOU SHOULD KNOW ABOUT PODIATRY CODING AND BILLING
Some of the most important employees you have in your practice are those who do your billing and collections. If you have only one employee responsible for a particular task or set of tasks, that employee is “holding all the cards” at salary review time. In addition, the only supervision this employee has is you.

Close personal review of everything that goes on in the office is almost impossible. In business, it is best practice to have a handful of employees cross-trained in all areas to protect your practice from schemes and embezzlement.

When hiring and training your billing staff, you should consider that podiatry coding is a continually changing field. You (as the physician) and your billing staff must continue to update yourselves on changes in billing codes and procedures.

Doing so will keep you out of trouble and help you take advantage of new opportunities. Plus, correct billing for services you perform will increase your potential profits.

IS OUTSOURCING THE ANSWER TO THE PODIATRY BILLING PROCESS?
Many physicians look at outsourcing as an optimal solution, as it curbs some of the issues mentioned above. Selecting the best billing service to use is paramount.

Here is a list of some questions you can ask of prospective billing services. These questions can help you decide if outsourcing is for you and assist you in finding the right one for your practice.

Does the billing service in question deal exclusively with podiatry?
Although it isn’t necessary for them to deal exclusively with podiatry, it is helpful if a large percentage of their business has a great understanding in that field. This ensures that they will be up to date on insurance and coding changes within the field of podiatry.

What are the service fees? What do they include? Is there a start-up charge? If so, how much?
These answers will help you make the decision whether or not it is financially worth it to outsource your billing. It’s important to keep in mind that most billing companies charge a percentage of the monies collected. Obviously, this would exclude money that comes through the office for things such as co-pays, lotions, creams, wound dressings, etc.

Is there a minimum amount for which the company will send a statement?
Knowing the answer to this question will enable you to plan your billing process accordingly.

How does information transfer between the practice and the service? How do the encounters transmit to the service (mail, fax, delivery service, or scanner)?
Obviously, it will be best if whatever method they use is compatible with your office and staff.

How does the practice access the information on each account? Is the information online? Can you download the financial information, or do you have to go to the service’s website to access the information?
Knowing beforehand how accessible the information will be to you and your client will lead to fewer headaches down the road and better client satisfaction.

Who handles the money?
All checks provided by both the insurance company and patient should go to the practice, not the billing service. The billing service should not handle any money. This protects both the podiatry practice and the billing service.

MAKING FINAL DECISIONS ON YOUR BILLING PROCEDURES
Overall, outsourced podiatry billing is not for everyone, and the best approach to take is a logical one. Calculate what you are paying now. Decide what involvement you, your partners, and your billing staff are comfortable with. Then find a knowledgeable billing company with positive reviews that handles mostly podiatry claims.

When making this decision, don’t forget to factor in security, office harmony, and peace of mind that your billing process is reliable and equipped with all of the latest insurance and billing changes.

THE BENEFITS OF OFFERING WOUND CARE PRODUCTS TO PATIENTS

If you have been in the podiatry field for any amount of time, then you know the importance of wound care products. Foot and lower-leg wounds require specialized wound care, particularly in patients who are at high risk for complications. Understanding the purpose of a dressing, the dressing categories, and what makes up a dressing prescription can improve the quality of care that podiatrists are able to provide their patients.

Podiatrists see patients with a wide range of conditions that can significantly increase the risk of wounds—from diabetes to peripheral artery disease.

And anyone who is susceptible to blood clotting due to age, genetic disorders, or lack of mobility needs specialized types of podiatry supplies to treat lower-extremity wounds.

Patients with wound conditions, be it minor or severe, can benefit greatly from a prescribed at-home wound-dressing regimen. It offers a convenient and affordable way for the patient to treat their wounds in the comfort of their own home.

This type of prescribing can also benefit the podiatrist’s practice by freeing up dressing time and offering a selection of wound care products for patients to purchase—many of which are billable to insurance.[1]

The podiatrist is often the hub when there are many different spokes to the wound-management team. Because wound care can often require specialists from various fields of medicine, the patient greatly benefits from the podiatrist’s ability to prescribe wound care products and communicate proper application.

A CLOSER LOOK AT WOUND CARE PRODUCTS
Alginate Dressings[2]
Alginate podiatry supplies start out dry, but when they come into contact with exudate fluids from the wound, they transform into a gel-like substance. This material helps clean out the wound, protect against bacteria, promote new skin growth, and encourage natural debridement.

Alginate dressings should be considered when there is an excessive amount of wound drainage since they can absorb up to 20 times their weight. Wounds such as pressure ulcers, diabetic foot ulcers, cavity wounds, venous leg ulcers, post-operative wounds, trauma wounds, and partial-thickness burns are all good candidates for alginate dressings.

Hydrogel Dressings
Hydrogel dressings are a great way to provide hydration to a wound. Hydrogels are made of 90% water and thus are helpful in maintaining a moist wound environment.

Hydrogel dressings generally come in 3 forms, including…

Amorphous hydrogel: a free-flowing gel, distributed in tubes, foil packets, and spray bottles
Impregnated hydrogel: typically saturated on to a gauze pad, nonwoven sponge ropes, and/or strips
Sheet hydrogel: a combination of gel held together by a thin fiber mesh
Injuries to the skin such as dry or dehydrated wounds, partial or full-thickness lesions, abrasions or severe scrapes, minor burns, wounds with granulated tissue development, and radiation skin damage all make good candidates for a hydrogel dressing.

The benefit of the viscous material is that it can reach the deeper layers of the wound to improve the quality of healing. It’s important to note that hydrogel dressings need to be changed more frequently than other types of dressing to prevent adhesion to the wound.

Collagen Dressings
Simply stated, collagen dressings can stimulate new collagen growth in wounds. They do so by supporting new cell development, which creates the natural framework that new, healthy tissue needs to grow. Collagen also controls many other cellular functions necessary to heal a wound. These functions include cell shape and differentiation as well as migration and synthesis of a number of proteins.[3]

Currently, there are numerous types of collagen dressings available. These vary with regard to type of collagen and concentration of collagen in the dressing. They are available in pads, powders, gels, and freeze-dried forms, all of which can be used with other dressing types around the toes and feet.

Compression Stockings
Compression stockings are helpful in treating patients with lower-extremity ulcerations. They are also widely looked at as a preventative treatment for certain disorders. They work by gently squeezing the calf muscles, which causes straightening of the vein walls and improves overall lower-extremity circulation.

When prescribing compression stockings, it’s important to remember that they are not “one-size-fits-all.” Likely candidates for compression stockings are people with or at risk for circulation problems. The following can contribute to circulation problems:

DVT (deep vein thrombosis)
Varicose veins
Diabetes
Recent surgical procedures
Mobility issues
Prescribed bed rest
Jobs that require standing for extended periods
Lengthy car or plane rides
Sports
Pregnancy
There is a very wide variation when it comes to size and level of compression. When deciding whether compression stockings are a good fit, a thorough lower-extremity examination is recommended.

WHAT ROLE DOES PODIATRY PLAY IN WOUND MANAGEMENT?
Simply stated, the role of podiatry in wound healing is essential. Podiatrists are often the last line of defense when it comes to lower-extremity preservation. By staying informed on what wound care products are available and providing patients with an affordable way to care for their wounds between visits, you are giving them the best possible outcome.

Of course, at-home wound care products cannot take the place of good clinical wound treatment. The dressings are meant to support best practices, not replace them. Wounds need to be well perfused, free from infection, compressed, and offloaded when necessary. That being said, successful wound treatment can prevent a lower-extremity amputation and be one of the most rewarding aspects of a practice.

[1] https://www.podiatrytoday.com/coding-and-wound-care-what-you-should-know

[2] https://www.woundsource.com/blog/what-alginate-dressing

[3] Brett D, A review of collagen and collagen-based wound dressings. Wounds. 2008;20(12):347-53.