How do podiatrists get paid?

[doctor in da makin]

Is it fee for service, capitation,or just a yearly salary?

I'd love to hear what you folks say...

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[NatCh]

Step-by-step:

1. See patient.
2. Propose treatment.
3. Wait for patient to "do research" online.
4. Wait for patient to verify with internet forum members that you know what you're doing.
5. Treat patient.
6. Dictate lengthy chart note with questionably valuable data for the sake of MU/MACRA/MIPS/Medical Home/Etc.
7. Click mouse 50 times to generate superbill.
8. Send superbill to Biller to verify that your ICD10 codes pair up to your CPT codes.
9. Send bill to insurance company.
10. Wait a few weeks for insurance company denial letter due to missing modifier.
11. Add missing modifier to superbill.
12. Resubmit bill.
13. Wait a few weeks for payment.
14. Answer three phone calls from patient to reassure him that you knew indeed what you were doing.
15. Wait a few months for letter from insurance company claiming overpayment and demand for refund.
16. Sign check to give money back to insurance company.
17. FML.

All clear?

 

[Weirdy]

Step-by-step:

1. See patient.
2. Propose treatment.
3. Wait for patient to "do research" online.
4. Wait for patient to verify with internet forum members that you know what you're doing.
5. Treat patient.
6. Dictate lengthy chart note with questionably valuable data for the sake of MU/MACRA/MIPS/Medical Home/Etc.
7. Click mouse 50 times to generate superbill.
8. Send superbill to Biller to verify that your ICD10 codes pair up to your CPT codes.
9. Send bill to insurance company.
10. Wait a few weeks for insurance company denial letter due to missing modifier.
11. Add missing modifier to superbill.
12. Resubmit bill.
13. Wait a few weeks for payment.
14. Answer three phone calls from patient to ensure him that you knew what you were doing.
15. Wait a few months for letter from insurance company claiming overpayment and demand for refund.
16. Sign check to give money back to insurance company.
17. FML.

All clear?

Could we have summed that up with "Getting f***ed by insurance company."?

 

[doctor in da makin]

Step-by-step:

1. See patient.
2. Propose treatment.
3. Wait for patient to "do research" online.
4. Wait for patient to verify with internet forum members that you know what you're doing.
5. Treat patient.
6. Dictate lengthy chart note with questionably valuable data for the sake of MU/MACRA/MIPS/Medical Home/Etc.
7. Click mouse 50 times to generate superbill.
8. Send superbill to Biller to verify that your ICD10 codes pair up to your CPT codes.
9. Send bill to insurance company.
10. Wait a few weeks for insurance company denial letter due to missing modifier.
11. Add missing modifier to superbill.
12. Resubmit bill.
13. Wait a few weeks for payment.
14. Answer three phone calls from patient to ensure him that you knew what you were doing.
15. Wait a few months for letter from insurance company claiming overpayment and demand for refund.
16. Sign check to give money back to insurance company.
17. FML.

All clear?

This might be a silly question. But how much do podiatry schools/residency programs actually teach you (if at all) on the ins and outs of insurance, how to get paid, how to navigate the whole world of "superbills", etc?

 

[bobtheweazel]

This might be a silly question. But how much do podiatry schools/residency programs actually teach you (if at all) on the ins and outs of insurance, how to get paid, how to navigate the whole world of "superbills", etc?

Little to nothing.

Sent from my Nexus 5X using SDN mobile

 

[bobtheweazel]

This might be a silly question. But how much do podiatry schools/residency programs actually teach you (if at all) on the ins and outs of insurance, how to get paid, how to navigate the whole world of "superbills", etc?

But in fairness, I'm not sure how they would. Different insurances have different standards for what is medically necessary (how to justify these things) and different requirements for you to get paid. On top of that these requirements and regulations change all the time. I guess maybe they could at least teach you how to code (now that we're caught up on ICD-10 with the rest of the world and probably will be for a while), but even that can vary between doctors or between insurances (if a particular insurance requires you to code/bill a particular way to get paid and another insurance needs it another way). It's very complex. But it does pay to stay on top of it, not only so that you can know you're billing the maximum you're allowed to but also so you can make sure you're not doing anything improper, because that can contribute to denials and having to pay back money. Though, plenty of times they'll still deny you even if you do everything right.

I blame the system more than the schools. You know, for whatever downsides there would be to single payer healthcare, a major upside would be that you would only need to keep track of the requirements of one insurer and a lot of this would be more streamlined.

Sent from my Nexus 5X using SDN mobile

 

[NatCh]

Is it fee for service, capitation,or just a yearly salary?

To actually answer your question, all of the above scenarios exist. It just depends on your situation.

 

[ldsrmdude]

Little to nothing.

While in general, I would say that you are absolutely correct, there are some residency programs that do a decent job of teaching billing and coding. I felt like I had a decent grasp of billing when I finished my residency. I spent a reasonable amount of time in a private clinic in residency and had some good attendings to guide me. I was probably one of the lucky ones. I think that residency is the right time to learn this, I don't think 2nd year of school is the appropriate time. Too much could change and nobody would remember any of it by the time you actually needed it

 

[ExperiencedDPM]

While in general, I would say that you are absolutely correct, there are some residency programs that do a decent job of teaching billing and coding. I felt like I had a decent grasp of billing when I finished my residency. I spent a reasonable amount of time in a private clinic in residency and had some good attendings to guide me. I was probably one of the lucky ones. I think that residency is the right time to learn this, I don't think 2nd year of school is the appropriate time. Too much could change and nobody would remember any of it by the time you actually needed it

The problem I've seen with that is if you put garbage in you get garbage out. In other words, if the attending doesn't really understand billing or thinks he knows the "tricks", he may be passing on bad information. Several years ago I was a consultant for an insurance company (they merged with another company and got rid of all consultants). The stuff I saw was amazing. The attendings often "figured out" ways to unbundle codes to get paid more even though they didn't do more. It's very easy to fraud insurance companies, but it's not something I recommend.

So please take what you learn from attendings and consider the source.

 

[doctor in da makin]

But in fairness, I'm not sure how they would. Different insurances have different standards for what is medically necessary (how to justify these things) and different requirements for you to get paid. On top of that these requirements and regulations change all the time. I guess maybe they could at least teach you how to code (now that we're caught up on ICD-10 with the rest of the world and probably will be for a while), but even that can vary between doctors or between insurances (if a particular insurance requires you to code/bill a particular way to get paid and another insurance needs it another way). It's very complex. But it does pay to stay on top of it, not only so that you can know you're billing the maximum you're allowed to but also so you can make sure you're not doing anything improper, because that can contribute to denials and having to pay back money. Though, plenty of times they'll still deny you even if you do everything right.

I blame the system more than the schools. You know, for whatever downsides there would be to single payer healthcare, a major upside would be that you would only need to keep track of the requirements of one insurer and a lot of this would be more streamlined.

Sent from my Nexus 5X using SDN mobile

Just like the actual Bernie Sanders, you support single payer lol

 

[bobtheweazel]

Just like the actual Bernie Sanders, you support single payer lol

Representin'