Billing for custom foot orthoses

Billing for custom foot orthoses

Paul Prusakowski

12/17/2007

Dear list,

 

I am looking for your advice and experiences on billing insurance for foot
orthoses.

 

Patients present with a signed Rx from their physician

In our practice we immediately assume that insurance will not reimburse for
traditional custom foot orthoses.

We provide financial counseling to the patient and have the patient sign an
ABN

We fabricate the inserts

We fit the patient

We bill the patient at delivery and accept Cash, Check or Credit Card.

 

The question I have is what are your practices from this point forward?

 

a. Do you then go ahead and bill the insurance company as a courtesy to
the patient so that the charge is documented as applied to their out of
pocket medical expenses for the year?
b. Do you provide the patient with the information that they would need
in order to send documentation to the insurance company themselves in hope
of reimbursement and also to provide documentation?

 

 

We have been submitting claims to the patient's insurance companies as a
courtesy, and deal with the expected denial in 95% of the cases. This has
become a time consuming practice for my administrative staff that is
basically an exercise in futility. I am wondering how others deal with this
scenario.

 

Thanks.

 

Paul E. Prusakowski, LPO, CPO, FAAOP

Gainesville Prosthetics