Medical Billing Articles

Best Practices and Tips for Podiatry Billing February 22, 2021

podiatry billing tips

Podiatry billing is said to be more challenging than other specialties. It involves different procedures making it more intricate as it requires meticulous coding related to where, when, and what procedures were made. It needs the most competent billers and coders who are up-to-date with the latest revisions of the requirements for Podiatry billing, code-specific regulations, and compliance standards. Even the smallest mistake or error could lead to denials of claims and loss of revenue. Here are the best practices and tips for Podiatry billing straight from our medical billing and coding experts: 

Podiatry Billing Tips and Practices

1. Update your Billing System and Software

It is important to utilize the correct billing system that suits your practice to keep up with today’s dynamic and rapidly changing market. It will help improve the efficiency, quality, and turnaround time by investing and implementing an acceptable EMR, billing system, and software.

2.  Include Comorbidities in Coding

Providers documents relevant conditions called comorbidities. Coding them will help you receive higher reimbursements. It also notifies the insurer about the additional cost.

3. Code Diagnosis Instead of Symptoms

Unless there are client-specific guidelines to code the symptoms, it is essential to analyze the medical reports and code the confirmed diagnosis instead of reporting symptoms. Similarly, the coding of additional disease-related symptoms should be avoided unless indicated.

4. Stay Current with the Billing and Coding Changes

The first step towards effective Podiatry billing is to guarantee that your team is up-to-date with the latest changes to the billing and coding guidelines. The guidelines for Podiatry-related procedures and medical billing are often updated and modified due to their complexity. It is essential that your Podiatry billing team stays current.

5. Audit your Medical billing and Coding Regularly

Podiatry coding and billing mistakes can appear unavoidable due to their complex nature. Having regular audits can help monitor the percentage of errors while at the same time helping to analyze their causes. It ensures consistent steps are taken to minimize recurring errors. The audit also helps you to consider the staff and provide them with extra preparation or retraining. ‘

6. Reevaluate Your Documentation Process

Podiatry billing can be challenging. Any documentation gap can result in missed billable codes, which would potentially hamper the practice revenue. Accurate and full documentation of the exact process is necessary to minimize the rejection of claims. Processing claims with insufficient and erroneous paperwork can be time-consuming and lead to delays in services.

7. Use Combo Codes Appropriately

Podiatry coders must be careful to follow different coding guidelines, such as “Code also,” “Use additional codes,” “Code first,” etc. When necessary, it is important to use combo codes to prevent claims that are rejected, delayed, and denied. However, lacking combo codes implicitly means missing the bill.

8. Outsource your Billing and Coding

You can always partner with a trusted name in medical billing and coding like us at 5 Star Billing Services. We focus solely on medical billing and coding so you can focus more on your clinical services. It will help reduce your turnaround time, overhead cost, and hiring and staffing. Our staff is regularly trained to increase your productivity and quality service.

Tap Into Our Expertise

At 5 Star Billing Services Inc, we offer the highest level of performance for high-quality medical billing. Let us help you during these dire times.

Schedule a consultation with our experts today!

Medical Billing Errors That Are Hurting Your Practice January 26, 2021

medical billing errors

Effective medical billing is the backbone of a successful practice. Thus, maintaining a healthy cash flow is every provider’s daily challenge. Any mistake, error, or delay will not only disrupt your flow but will also negatively affect your patient experience and patient retention. Therefore, it is essential to determine blockages that are hurting your finances. It will make it easier for you to streamline your processes, minimize errors, and improve the overall patient experience. We’ve gathered the top five medical billing errors and how to solve them: 

1. Limited Payment Options

Delay in your payment collection clogs up your cashflow. Consumers, including patients, prefer to settle their bills online through bank transfers, Amazon pay, PayPal, or credit cards. If you don’t offer at least some of these, that’s a problem.  Patients will pay more promptly if you give them a variety of payment options. 

Equip your patient portal with online payment options that comply with HIPAA and HITRUST standards. It will make it easier for your patients to pay you, increasing your patient collection in the process.

2. Incorrect Patient Data

Patient details are the foundation of your medical billing process. One typo on a patient ID number or name can get your claims rejected immediately. Always remind your staff to not just double-check, but to triple the effort using claim scrubbing software that can automatically detect typos, errors, or missing information.  

3.    Inaccurate Coding

Always get the updated version of your coding books. Coding guidelines, procedural, and diagnosis codes are updated annually. Coding errors are inevitable no matter how seasoned or experienced your staff may be. Make it a habit to conduct training or refresher courses for your staff for ICD-10 coding updates. 

4. Manually Managing Your Claims

There are still providers who are using a manual process for their denials management. If you are one of them, then it’s time for you to embrace medical billing innovations. You can get more 

insights through better analytics and improve your medical practice using automated EHR/EMR solutions integrated into your medical billing software. Some software has a checklist and alerts to ensure proper coding and billing practices. 

5.  Sending Claims to the Wrong Insurer

Sending the claim to the incorrect insurance provider is one of the simplest medical billing errors you can avoid. Usually, it happens because you do not have a copy of the patient’s insurance card. In order for you to send it to the right insurance company, always secure a copy of the front and back of the insurance card. Always ask the patients if there are any changes to their insurance, too. 

By eliminating the top billing mistakes in your medical practice, you can shorten billing cycles, maintain healthy cash flow, prevent regulatory violations, and deliver a better patient experience that will help you retain more patients and become more profitable.

Tap Into Our Expertise

By being aware of your medical billing errors, you can easily remove your blockages and improve your cashflow. At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. Let us help you during these dire times.

Schedule a consultation with our experts today!

Medical Practice’s Financial Stability During Crisis January 19, 2021

medical practice financing

Medical practices of all sizes have felt the tremendous impact of the global pandemic on their revenues. Practices are struggling to stay afloat and we fear that it might just be the beginning. According to the Medical Group Management Association (MGMA) survey, revenues of medical practices were cut in half at the start of the pandemic. It also showed that patient volume declined to an average of 60 percent. 

How to Achieve Financial Stability 

Medical billing experts and industry leaders shared their best ways to remain financially and operationally stable during the pandemic at the MGMA’s Medical Practice Excellence Conference last October 24-27, 2020. The main theme of the conference was revenue cycle management and financial survival of practices. They emphasized the importance of optimizing revenue capture and reimbursement to offset losses. Check out the three strategies on how you can stay afloat financially and regain your losses from the pandemic.

1. Ensure Optimal Productivity

Carol Wanke, vice president of post-acute revenue cycle and managed care operations of Sharp Healthcare, shared tips on how to increase productivity via KPI and workflow monitoring. They use granular data on employee productivity to ensure outstanding work and to keep the staff motivated. They focus on finding new and innovative ways for employee motivation and recognition to boost morale. 

The CFO of Graves-Gilbert Clinic, Steven Sinclair, also highlights the role of productivity for their success in maintaining financial stability. They are the only independent medical practice to attain MGMA’s Better Performer status in 2020. The MGMA data also shows that practices can boost their productivity by keeping a standard of performance for employees, investing in facilities, and staff.

2. Adaptive Leadership

The pandemic emphasized the need for great leadership. If you don’t do well under pressure and adapt to change, then your practice will suffer. The need for adaptive leadership with a good initiative and the ability to think outside the box has never been more important. According to Sparrow Hospitals Alan Vierling, MSN, adaptive leadership is effective in the sense that it can establish a singular vision or set priorities straight. For example, finding ways to ensure top safety for all nurses and staff. He also added that effective leadership will always communicate and remain visible.

3. Smart Use of Physical Space and Technology

The pandemic brought new healthcare normal to the world. There are now social distancing requirements for every establishment and an emphasis on the use of Telehealth. Practices are looking for new ways to use their locations smartly and delivering effective alternative care. You need to set the right mix of remote and in-person services for your clinic. Workflows will be recreated, adapting more to technological advancements. 

Tap Into Our Expertise

At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. Let us help you during these dire times.

Schedule a consultation with our experts today!

Importance of Adding Empathy in Medical Collections December 16, 2020

Medical costs are becoming an overwhelming burden. Many patients have been left in a state of harrowing medical debt.  Now, more than ever, empathizing with the plight of your patients is key for your practice.

Rising Debt Due to Medical Expenses

High deductible health plans are one of the main reasons why medical costs are rising. 

These changes ballooned the debts of patients with unpaid medical bills. Statistics show that 20% of working Americans with health insurance were unable to pay their medical bills. Reports also show 31% of working Americans use money from their retirement, college, and savings accounts to pay their medical bills.

However, independent practices show better patient collection rates than larger health practices.. That’s due to a higher quality of patient-provider communication, giving a more intimate patient experience. Empathy is one important factor that makes this possible and here’s how you can add it to your medical collection philosophy:

How to Empathize in Medical Collections

Show Understanding and Compassion 

Always keep in mind that patients are going through problems,  including medical grief, health, financial problems, or crushing debt. Thus, approach them with empathy when discussing financial matters and give them little gestures of kindness. It could be a simple comforting smile or perhaps asking how they are doing. Patients are more likely to open up to you when you convey positivity, comfort, and kind gestures.

Offer other options

A Federal Reserve survey reported that 47% of Americans have an unpaid emergency medical bill of $400. If a patient can’t pay the bill immediately, remember that they might have a lot on their plate. Patients have multiple bills and debts to manage, even if the amount seems small to you. You can show your support and care for them by offering payment plans or accommodations which can increase patient loyalty.

Provide a Warm and Friendly Customer Service

Providing not only just quality customer care but a warm and friendly one is highly appreciated in any practice, especially in medical collections. Your billers should have always aim to give the best customer service by being empathetic so they can maintain a compassionate interaction.

Observe their Body Language

Remember that a patient’s ‘ financial situation can be a very delicate issue. They could’ve lost a job or they may be having financial problems. Empathizing can simply mean putting yourself in their position. Try to take note of their body language and notice any signs of anxiety and stress. You can offer emotional support through kind gestures and talking to them to give hope and comfort in their situation

Tap Into Our Expertise

At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. We understand best how important empathy is in medical collections. Talk to our experts to further improve your collections and be more empathetic to your patients. 

Schedule a consultation with our experts today!

Develop Patient-Friendly Medical Billing During Pandemic December 9, 2020

A patient-centric approach means you need to design a system that places the needs, preferences, and behaviors of patients at the center of the experience of healthcare. It holds the key to attracting fresh patients and retaining existing ones. The whole idea revolves around a carefully designed user journey that delivers an outstanding patient experience. You need to ensure that every touchpoint meets their expectations since patients now hold medical practices to the same standards as other consumer services. 

The patient billing statement is one patient touchpoint that often gets overlooked. It’s often treated as an afterthought. However, you can’t afford to overlook the payment process if you want patients to be satisfied with their entire experience and return to your practice or facility. A badly designed or confusing billing statement not only reduces patient satisfaction but also makes collecting unpaid balances more difficult.

It’s time to upgrade your medical billing statement!

Essential Elements of a Patient-Friendly Medical Billing Statement

A patient-centric statement presents billing information in a way that helps patients understand the charges and give them easy ways to pay the bill, access additional information, or get assistance.

Here are some essential elements to consider when designing a patient-friendly billing statement:

Integrated Statement

Patients often have to receive care within a facility from various providers or departments. When they have to deal with multiple bills from different services, e.g., radiology bills, laboratory bills, and doctor’s bills, it is a frustrating experience. 

You need to display all charges in one place so that patients can easily understand the breakdown of the charges and the total for the entire visit. Consequently, the itemization of each service or treatment makes it easy for patients to identify the suppliers, services, and costs involved. A consolidated bill also makes it easier and faster for patients to make payments while ensuring that they do not ignore a payment just because a bill is lost in the pile.

Easy-To-Understand Presentation

The use of jargon and complicated format in billing information presentation is often frustrating for patients. By using jargon-free language in your statement, you can enhance the patient experience and include explanations of the terms in the FAQ section. Colors can also be used to link financial data and design elements to highlight the next step so that patients can take the necessary measures.

Payment Options

You have to make it easy for patients to pay the bills proactively. Offer detailed instructions on how to access the online payment portal or send a payment. Patients should also be able to make payments by phone or online, in addition to the traditional option of sending a check with a payment coupon. Thus, offering a payment plan option is another way to encourage patients to pay. Include information about it alongside the payment instructions so that patients can contact your office for further queries.

Clutter-Free Statement Design

Your billing statement should be easy to comprehend by showing only the relevant information that patients need. By including a URL and/or QR code, you can provide a way for those who require additional details or access to medical data online.

Tap Into Our Expertise

At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. We offer a text notification feature for sending bills to your patients and they can access their billing statements through our Patient Portal too. Talk to our experts to further improve your collections and achieve a patient-friendly medical billing

Schedule a consultation with our experts today!

Denial Management and Prevention Tips for Your Medical Practice November 23, 2020

Denied claims eat away 6-8% of a healthcare provider’s overall revenue. It hampers the financial stability and the growth of a practice. Contrary to popular belief, 90% of denied claims are actually preventable. You just need to take your denial management and prevention to the next level. We’ve gathered the best tips to stop these revenue leaks: 

1. Monitor you progress.

First, assess your denial management process frequently. You need to discern what’s working and what areas need improvement. To know your progress, you need to document all wins and losses for your unpaid claims. Thus, you’ll be able to use that data to improve the efficiency of your denial management strategies. 

2. Recognize why claims were rejected.

Understanding the causes of your denied claims will help streamline the process of maximizing your revenue collections and prevent the denial of future claims. Not all of your patients are knowledgeable about when their claims are being denied by insurance companies. Thus, it is your responsibility to educate them when tackling the issue. In connection, It is also important for the overall performance of your company to be able to assist them in a timely manner.

3. Identify the most common denials and trends.

Try to identify the types of denials that are most common to your organization. Initially, each form of denial can seem like a minor issue, but when you begin to track and examine these patterns, it can lead you to the root cause of some major problems in your organization.

4. Establish Incentive Programs

To motivate and encourage healthy competition, rewards and incentives should be put in place. Your staff should have the right motivation not only to successfully appeal denials but to recognize trends, share knowledge, and have great camaraderie.

5. Expedite your Denial Management Process

Denied claims may pile up over time and it may easy to lose track, which may lead to serious problems in the future. Utilize the latest technologies and tools that help you keep track, manage, and expedite your denial management processes. 

6. Do it within a week

You need to set high standards for timeliness in processing your denied claims. An effective tracking system would lead to more efficiency and help impact all factors of your practice. If you get a rejection from an insurance provider, there must be a procedure in order to ensure that the denial is handled in less than a week.

7. Leave it to the experts

You can never go wrong in outsourcing your medical billing and denial management processes to a trusted name in healthcare. It will surely give you the financial prosperity and stability that you always desired. Specialized teams that are highly trained in handling the complexities of the insurance system are used by the top denial management providers. You’ll have more time to focus on your core competencies by outsourcing your denial management needs.

Tap Into Our Expertise

At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. Let us help you during these dire times.

Schedule a consultation with our experts today!

How COVID-19 Is Changing the Medical Billing Process November 19, 2020

The pandemic continues to overwhelm the globe. Economies are in a recession. And hospitals and private practices throughout the United States are absorbing a lot of the brunt. They are barely holding on due to the decline of outpatient and non-urgent treatment procedures. In addition, the pandemic also brought a lot of changes in medical billing. Thus, adapting to your practice’s survival has never been more critical. 

How Medical Practices are Thriving

The Inbox Health Survey reports that 21% of 1200 medical billers forecast that 10-25% of their practices may shut their doors for the next six months. Luckily, over $100 billion has been provided by the US Congress to help medical practices, hospitals, doctors, and other healthcare professionals through the Public Health and Social Services Emergency Fund. However, many fear that it may not be enough.

Changes in Patient Interactions and Collections

Most of the 1,200 Inbox Health Survey respondents observed a great decline in their patient volume and interactions. Subsequently, it results in a 10% to 25% drop in collections. It intensifies the struggle to survive and cope in the middle of a global pandemic and recession. 

How to Cope with the Medical Financial Crisis

The following are the vital keys that you need to consider to cope and survive and achieve financial sustainability amidst the pandemic:

  1. Adjust operational accommodations
  2. Record changes in standard referral requirements
  3. Adapt to the rapidly changing rules and regulations in billing and coding, especially with Medicare and Medicaid.
  4. Take note of the following questions regarding Telehealth: 
  • The total sum of coverage
  • Extra documentation for medical necessity
  • Prior authorizations and required approvals
  1. Tighten remote medical billing plans to minimize cash flow issues
  2. Account for changes in copays and deductibles
  3. Optimize your resources according to a surge or drop in patient volume

How to Adapt Effectively to the Changes

For healthcare organizations struggling to cope with the pandemic, it is vital to keep their facilities open and to improve their medical billing operations. The Strata Decision Technology reported a massive drop in inpatient procedures at the start of the pandemic. Here are some keys to generating revenues and rebuilding financial capacity: 

  • Provide telehealth services
  • Implement s safe social distancing plan in the clinic
  • Adapt innovative healthcare technologies like telemedicine
  • Gain the patient’s trust and confidence
  • Secure necessary supplies for a patient surge
  • Conduct strict precautionary measures in the clinic

Telemedicine’s Role in the New Normal

Telemedicine services and technologies have been the greatest help in medical advances in health care due to the pandemic. It played a great role in keeping healthcare organizations afloat and lowering the risk of infection for patients. Undoubtedly, it will continue to do so in the post-COVID era. The CMC even reports that telemedicine catered to over 9 million patients during the first few months of the pandemic.

Telemedicine technologies made it possible for healthcare facilities to provide safe treatments to non-COVID and COVID patients. It enables small practices to continue their operations and even extend the lengths of their services. Patients can easily book their consultations online. It opened new gates of healthcare convenience, proving to the world that it is not just a mere temporary aid for the pandemic. Hopefully, it will continue to widen the scope of remote services well into the future. 

Tap Into Our Expertise

At 5 Star Medical Billing, we offer the highest level of performance for high-quality medical billing. Let us help you during these dire times.

Schedule a consultation with our experts today!

Increasing Practice Revenue by Outsourcing Billing April 20, 2018

Outsource medical billing

Clinics busy with patients, doctors and staff can gain considerable benefits by thinking about how to streamline their workflow and make key elements of the practice more efficient. One area to consider is the revenue process and whether the needs of the practice are best met internally, or through the utilization of an external billing service. Practices need to ensure that they are getting the highest amount of revenue possible, and it is a worthwhile exercise to evaluate the billing system and processes. It’s a decision that requires some thought, weighing up the individual needs of the practice and considering the pros and cons of outsourcing before making the decision about which approach is most suitable. (more…)

Successful Medical Billing in 2018 January 24, 2018

new year medical billing

Billing in the new year, 2018, can come with a range of challenges for any size practice. From the extensive administrative burden of billing, to the time taken to get authorization from insurers, and preparing complex patient statements; it can be a difficult time that feels like a heavy weight on your back with ‘significant challenges’ being recognized in industry reports on billing. (more…)

How to Turn Your Revenue Cycle Management Process Around September 25, 2017

Revenue Cycle Management

The efficiency of the your practice’s revenue cycle can have a critical impact on financial performance, and effective management of the cycle is of utmost importance to your practice. However revenue cycle management within health practices is becoming increasingly difficult, with greater administrative responsibilities and regulatory pressures. This article outlines the problems practices are facing and how to turn the revenue management process around.


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