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Reference to a medical biller?

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  • Reference to a medical biller?

    A podiatrist client is starting a side gig (IC) with a hospital and thinks he can do the billing better himself (thinks the hospital is "screwing it up"). He needs advice from a medical biller, specifically coding/billing for podiatry (of course). Willing to pay for the consult. Any referrals out there? He is in CA, if that matters.
    My passion is protecting clients and others from predatory and ignorant advisors 270-247-6087 for CPA clients (we are Flat Fee for both CPA & Fee-Only Financial Planning)
    Johanna Fox, CPA, CFP is affiliated with Wrenne Financial for financial planning clients

  • #2
    The specific question he has is:

    "...if I perform a service 11721 at a POS 13, should it be a facility or non facility fee?"

    Maybe a podiatrist on this forum has the answer? Grateful for any advice!
    My passion is protecting clients and others from predatory and ignorant advisors 270-247-6087 for CPA clients (we are Flat Fee for both CPA & Fee-Only Financial Planning)
    Johanna Fox, CPA, CFP is affiliated with Wrenne Financial for financial planning clients

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    • #3
      I know someone who should be able to answer, give me a couple hours and I will revert.

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      • #4
        If I understand the question, in my world, pos 13 means assisted living center and for us answer is unequivocally non facility. However I am not a podiatrist or a biller.

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        • #5




          I get worried when people feel they can code better but ask what seems like something they should know. I could train a coder for my codes and I believe most doctors should get to that level. I believe it’s just like investing. Hopefully a podiatrist comes along with your answer though.
          Click to expand...


          I do understand what you're saying and I tend to agree. In this specific situation, it appears to be more egregious in that he believes the hospital is making errors and charging a high fee. I'm just the advisor trying to find a solution, though.
          My passion is protecting clients and others from predatory and ignorant advisors 270-247-6087 for CPA clients (we are Flat Fee for both CPA & Fee-Only Financial Planning)
          Johanna Fox, CPA, CFP is affiliated with Wrenne Financial for financial planning clients

          Comment


          • #6
            As Q-School stated above, POS 13 is an assisted living facility. If OP is working at a hospital (i.e. employed/W-2), and the physician is travelling to the ALF it is non-facility.  Perhaps the hospital medical biller is billing as facility?  Reimbursement is likely higher under facility vs non-facility.

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            • #7
              Add on:  The code is for a nail debridement and is a common procedure in an ALF.  Medicare comps + or - $45 for this code.

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              • #8
                WCICON24 EarlyBird


                Add on:  The code is for a nail debridement and is a common procedure in an ALF.  Medicare comps + or – $45 for this code.
                Click to expand...


                Yes, this is an ALF. Will pass all of the above along. Mucho gracias!
                My passion is protecting clients and others from predatory and ignorant advisors 270-247-6087 for CPA clients (we are Flat Fee for both CPA & Fee-Only Financial Planning)
                Johanna Fox, CPA, CFP is affiliated with Wrenne Financial for financial planning clients

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