DOES DOING YOUR HOMEWORK
PAY OFF?
" They ones watching out for you is you, and the PFA. "
percent of Medicare allowable as the insurance
companies decided it should be. One wonders
where the other thirty-five percent is going.
And to make matters even more interesting,
we must constantly check to see if the annual
deductible is paid because if it is not, it’s on you
too, and you can’t bill the patient for it. Oh, and
don’t forget, the two percent withholding for
“sequester” that is still being collected for many
services.
WHAT CAN YOU DO?
While this is all very disconcerting, it is the
situation as it exists. Practitioners have to base
their business decisions on what they want to
do and how little they will take for their work.
Certainly the cost of obtaining goods has not
been reduced even as our reimbursements have
not been raised.
USE TECHNOLOGY: All insurance carriers
now have a website where you can go to do
research work. These websites contain a lot of
42
Pedorthic Footcare Association www.pedorthics.org
information, though you still will have to wait to
talk to a human at some point in the transaction.
GO PAPERLESS: The advent of websites also
allows you to submit your claims through these
websites. You will find out fairly quickly if there
is a problem with a claim and then correct it.
There are quirks with these programs as well, so
be prepared for them. The advantage is that it
takes at least two weeks out of the reimbursement
schedule by not dealing with paper claims.
HIT THE PHONES: Spend the time at the
outset to check for eligibility and patient
responsibilities. Time is money, your time, your
money.
Just as the physicians have to practice defensive
medicine, pedorthists have to practice preventive
insurance reimbursement. Know what you are up
against and plan accordingly. The ones watching
out for you is you, and the PFA. If you have
specific questions, either contact PFA or email
to: [email protected].