How to Remove Orthotics Billing Bottlenecks

Understanding The Challenges of Orthotics Billing

Orthotics billing shares many of the challenges faced by health care providers in other specialties. The need to be accurate, quick and thorough is very much the same as in other forms of medical billing. What tends to make matters a little more difficult in the case of Orthotics billing is the fact that billers need to be an extra bit more careful about coding. Of course, one also needs to stay updated about the latest payer norms and regulations to do justice to the stringent demands of the billing job. But coding correctly for the maximum reimbursement is one area that demands some extra attention.

It is a common sight where collections are found to get compromised because of overlooks in the coding section. It is of critical importance for any O&P (Orthotics & Prosthetics) practice to be able to distinguish between CPTs and L codes. But that’s not all. There are other important considerations too. One must be careful to code and bill right-foot and left-foot orthotics on separate claim form lines with the appropriate code, accompanied by the correct “-RT” or “-LT” modifiers. It is advisable to check back with the provider in case the codes provided are found to be insufficient in accurately describing the orthotic work done for the patient. It would be unwise to try using a catch-all or unlisted code (such as the CPT 29799—unlisted casting code) indiscriminately, especially where a more appropriate code is available.

Gearing Towards a Better Billing Experience

Unless a practice effectively deals with such challenges in Orthotics billing, it stands to suffer from reduced profitability. Collections can take a bad hit and the entire revenue cycle can get compromised. While having a panel of experienced, skilled billers & coders working for you is a great idea, it often gets too difficult to assemble such a team. The main impediments are cost and the hassle of finding the right people. This is why a large number of O&P providers across the U.S. are opting for specialized, third-party assistance in their billing matters.

Owing to their offshore location and a natural pool of local talent, these billing companies are able to provide a wide range of services pertaining to the revenue cycle of health care practices, at a cost that is substantially less than the usual cost of getting them through a regular, in-house staff. The benefits, however, don’t stop there. With their professional intervention and specialized skills, most practices who engage them experience an overall ameliorative effect on the billing process. Denials get reduced, collections increase and the entire revenue generation cycle gets streamlined. And these are the kinds of benefits that make offshore outsourcing such an attractive prospect for health care practices everywhere.