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02/15/2017
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS)
RE: Orthotic Coverage and Payment
From: Alan L. Bass, DPM
Here's a strategy employed in my office regarding coverage for orthotics.
1. First, employ a real-time, online, integrated insurance eligibility checker to see if the patient has DME coverage. Also see if the patient has a deductible for DME. While this does not provide information about specific codes, it tells you immediately if the patient even has coverage to submit the claim.
2. Next, create a form to give to the patient that has the ICD-10 and CPT codes that are used for the casting and billing of the orthotics, in addition to other questions such as the deductible. Tell the patient to call the insurance company using the number on the back of their card. Do not have your staff contact the insurance carrier.
3. When the patient returns for casting of the orthotics, have them sign the reverse side of the form that contains a financial responsibility for this service (in addition to the financial responsibility policy you have for your office).
Alan L. Bass, DPM, Manalapan, NJ
Other messages in this thread:
05/29/2020
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS) - Part 1B
From: Dennis Shavelson, DPM
Dr. Udell has selected cases that cannot be handled well via telemedicine unless we are in a pandemic and under stay-at-home orders. I wonder what he did with those of his patients with infections while his office was closed?
I am adaptogenic. I practice three blocks from The Freedom Tower and I estimate 30-40% of my patients will be working full- or part-time from home forever! Their acculturation has forced me to permanently adapt or close my practice. I am casting and dispensing custom foot orthotics wearing headphones, using my biomechanics. I am assisting injured athletes, essential workers, and stay-at-home exercisers who have nowhere else to go but their laptops. I am dispensing kinesiotape, CBD patches, and wearable resistance bands from my den. I am teaching home pedicures as a professional mentor and monitor to the delight of old and new patients. I am Zooming, Skyping, and Facetiming.
Elliot, what is going to happen to the DPM practices that were seeing 40-75 patients, and let’s not forget the nail salons, gyms, and yoga studios? I know, telepedicures, telehome workouts, and teleyoga. Not kidding.
Dennis Shavelson, DPM, NY, NY
05/11/2020
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS)
From: Allen Jacobs, DPM
1. Record your diagnoses.
2. Record your recommended treatment.
3. Record the patients’ refusal of treatment.
4. Record your discussion with the patient of possible complications from non-treatment.
5. Record the patient expressing verbally (or by other means of communication when appropriate) an understanding of potential complications from non-treatment.
Sadly, it is your job to produce extra documentation under such circumstances. Simple phrases such as “patient refused or declined" may or may not prove to be sufficient. Ultimately, the patient has the right to accept or decline treatment. Patient autonomy is the first principle of medical ethics.
Allen Jacobs, DPM, St. Louis, MO
05/08/2020
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS)
From: Lisa Fuchs, DPM
In response to failure to treat by keeping offices closed during the corona pandemic, I wanted to address an issue even during regular times. On occasion, I have a patient coming in for nail care, and I notice tinea pedis as well, so I discuss with the patient treatment options for that. The patient will say he doesn't want to treat it and asks me to ignore it.
I can't treat some things and ignore others. I've seen patients get admitted for a bacterial super infection from tinea pedis. I wouldn't want that to happen to anyone, even though it's not common. I also think on the off chance that does happen, the patient can file suit because of failure to treat. I don't want to open myself to that possibility.
Lisa Fuchs, DPM, Manhasset, NY
02/17/2017
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS) - PART 1A
From: Jeffrey Kass, DPM
Dr. Udell - the problem is worse than you describe. When the patient goes to Hanger, unlike you, they will be reimbursed at a fair rate. They will profit.
Jeffrey Kass, DPM, Forest Hills, NY
02/17/2017
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS) - PART 1B
From: Ira Baum, DPM
My policy was simple and very effective. All patients who were recommended orthotics were informed that we do not accept insurance as payment for orthotics. We had them sign a detailed waiver and leave a 50% non-refundable deposit.
I informed patients that if they want their insurance company to pay for their orthotics, I would reimburse them when the payment was received, but not more than they paid me. If that was unsatisfactory, I politely told them to find another podiatrist because insurance reimbursement did not cover my costs. It was also my policy never to write an Rx for orthotics. What I would provide is the "need" for orthotics, but not the Rx. Why would I take responsibility for the quality of a lab I didn't know and have patients come back and complain and waste my time?
Ira Baum, DPM, Naples, FL
11/30/2016
RESPONSES/COMMENTS (PRACTICE MANAGEMENT TIPS)
RE: Show Your Heart to Referring Physicians
From: Hal Ornstein, DPM
Each community has organizations to help less fortunate during the holidays in December. A simple way to show your support is by creating a Holiday Giving Box in your office. You can also make some additional boxes to distribute to other local physicians and businesses. Buy a bunch of gift tags and on each, write the age and gender of a child and use double-sided tape to put on outside of the box. Be sure to put a small sign that indicates that toys should not be wrapped and give a date to have them dropped off to your office. When gifts are delivered to the group designated to receive and distribute them in the community, take a picture, write a short press release, and submit them to the local papers.
Hal Ornstein, DPM, Howell, NJ
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