Does Your Practice Need A Billing Service?

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Michael Forman, DPM, FACFAS

   Podiatric coding is a constantly changing field. The doctor and his biller(s) must continue to update themselves on changes in billing codes and procedures. This is necessary to keep you out of trouble and take advantage of new opportunities to bill correctly for services you perform. At a minimum, those involved in billing (which should always include the doctor) should attend at least one podiatric billing course, read Codingline ( ) by Harry Goldsmith, DPM, and one of the coding manuals such as Podiatry Coding and Billing Alert.

Is Outsourcing The Answer?

Outsourcing your billing may solve many of the aforementioned problems. Selecting the best billing service to use is paramount. Let me suggest some questions you can ask of a prospective billing service to help you decide if this is for you and assist you in finding the right one for your practice.

   1. What percent of the billing service deals with podiatry? It is not necessary to have a service that is exclusive to podiatry but it is important that the service is experienced in dealing with the nuances of our billing. We contend with Q codes, toe modifiers, identifying primary care physicians, date of last service, listing the code in proper sequence, and multiple procedures per date of service (11720, 11719, 11055 and maybe a 10060). If the answer is, “Yes, we have podiatric experience,” your next question is “How many podiatric clients do you currently service?”

   2. Does the service have many employees working your account or is there one person who is responsible for your billing? If the person responsible for your billing is ill for a day or longer, or leaves the service, who will take on the responsibilities of your account?

   3. What is the time interval between receiving the encounter form and the time the insurance company or patient gets a bill?

   4. How does the service produce the encounter slips? Can the service produce the patient information on the encounter form such as previous balance or insurance company?

   5. What are the services’ fees? What do they include? Most services charge between 6 to 8 percent of the gross monies collected. This should not include payment for services that your office collects (i.e. cash visits, creams, lotions or pads). Does the fee include statements, stamps and stationery?

   6. Is there a start-up charge? How much?

   7. Is there a limit on the number of calls the office can make to the service requesting information?

   8. Is there a minimum amount for which the company will send a statement?

   9. What is the policy on collections? How often does the service send statements? How many statements do patients receive before “further action” is required? What are the “further actions” they provide? When is legal action advised and does the practice make the final decision on that?

   10. What reports can the billing service generate? Can it separate charges and payments by physician and location? Can it send you a copy of one of these reports as well as a copy of an accounts receivable report? Are these easy to read?

   11. 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 Web site to access the information? Who handles the money? All checks by both the insurance company and patient should go to a lock box, not the billing service. The billing service should not handle any money.

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