- July 7, 2022
- Posted by: Steve Smith
- Category: Orthotics Billing
Getting Started with Orthotics Billing
The world of orthotic and prosthetic devices is a vast one, populated by devices and supplies of various kinds. Naturally, when it comes to Orthotics billing, one should brace (no pun intended) for a good deal of diversity and complexity. Billing for orthotics and prosthetics is prone to many slips, every single one of which can be instrumental in getting a claim denied, or even rejected. The first of these is verifying the benefits offered by the patient’s health plan and checking their eligibility. There are many plans that do not cover orthotic devices. The provider’s office should get in touch with insurance company to ensure if a proposed orthotic device will be eligible for reimbursement. This will allow both the patient and the provider stay on the same page regarding the fees involved and who would be responsible for paying them in the end.
If coverage is available under a specific plan, the amount will be tied to a predetermined fee schedule, and the beneficiary will be bound to it. It is important to scrutinize the schedule closely so that no due reimbursement is missed. For example, if it is found that the fee is too low, one should make sure that the fee is for a single orthotic and not for a pair. The contract regarding orthotics can be renegotiated to make sure it is worth everybody’s while to dispense or use them.
The Smart way To Avoid Surprises
The checks mentioned above are just a few of the many that are required to ensure that are no unpleasant surprises when the time comes for paying for the devices or supplies. However, clerical errors, a casual approach to the billing affair or simply, a failure to communicate in time, can lead to disappointments. It is often seen that such slips are common with a regular in-house billing staff. In most cases, such staff is already overburdened, or simply not competent enough to ensure 100% accuracy.
This is the reason why a growing number of Orthotics & Prosthetics providers across the U.S. are choosing to outsource their billing to dedicated, offshore billing partners. One of the most important ways in which providers can benefit by engaging such specialized intervention is in bringing about an overall improvement in the rate of collections. Their revenue cycle gets more streamlined, denial rates drop sharply, more bills get passed in unit time and profits increase. Available on low hourly rates (or sometimes, on a fixed percentage of total collections realized), these offshore agencies can be a real lifesaver when everyone is worried about rising inflation rates.