PRESENT - New Docs on the Block Newsletter
Medical Billing


by Jordan R. Stewart, DPM
Timonium Foot and Ankle Center
Established July 2006
Timonium, MD

As a resident, I made a conscious effort to learn medical billing. I read numerous articles and discussed billing scenarios with my attending doctors. When I started my practice, I had the option of doing my own billing or using a billing service. I never considered a billing service. As a new practitioner and a business owner, I recognized that learning to do my own billing would allow me to maximize profit and comply with the guidelines set forth by Medicare and the private insurance companies.

As you transition from residency to private practice, a new "training program" begins. Just as it takes a few years of residency to learn surgery, it will take time to learn billing and coding. I have learned a lot over the past 6 months, making several mistakes along the way, and I will only continue to learn as time goes on.

If you are not familiar with coding, review the ICD, CPT, and HCPCS coding books. This will seem overwhelming at first, but as time goes on you will know these codes like the back of your hand. Several podiatry coding books exist. Invest in one or more of these texts and read and participate in the coding forums available online.

Many doctors take the attitude that their staff will handle all of the billing issues. Nevertheless, it is the doctor's responsibility to know the insurance guidelines and bill in accordance with these guidelines. If these rules are broken, you are ultimately responsible and this could have a significant impact on your reputation and your wallet.

For several years, a healthy 50-year-old male presented to a podiatrist every 3 months to have a callus trimmed on the ball of his foot. This was the only service provided and was billed to the insurance company as an office visit for several years. After the patient's doctor retired, the patient presented to my office for treatment. I informed the patient that trimming the callus is not covered by his insurance plan under the current rules, but instead an out-of-pocket expense. The patient wrote me a letter telling me he would only come to see me if I billed the service through his insurance. I kindly informed him that I would not bill the procedure as an office visit and he did not come back to my office. This scenario demonstrates the importance of knowing the services covered by the insurance company and billing in accordance with current guidelines and not just what other doctors may have done in the past. It is absolutely essential to follow the rules from the get go so you do not have to worry about inappropriate billing and its consequences.


Jordan R. Stewart, DPM
A PRESENT New Doc Editor
[email protected]

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