Designed specifically for the unique needs of the foot care specialty, MedCare MSO’s billing software ensures accurate, timely reimbursement, including Medicare routine foot care requirements, DME claims, diabetic wound care tracking, and more every time your practice submits a claim.
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Trusted by 1000+ providers
Reduction in AR
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Podiatry billing isn't just a simple claim submission. Whether you are dealing with diabetic foot care, billing for orthotics or complying with Medicare routine foot care needs, practices require software that is tailored to the podiatry workflow. MedCare MSO's API automates all coding validation, recurring treatment billing, eligibility verification, and denial prevention to help practices maximize collections and minimize administrative workload.
We receive secure ERAs from a clearing house (via SFTP, VPN, API), and EOBs via an encrypted portal, along with the batch of ERAs that are verified against bank deposits (BAI/NACHA) before these are posted. The ERA total should match the total deposits.
Our system parses all ANSI 835 files by segment, such as ISA/GS envelope, BPR (financial), TRN (trace number), CLP (claim payment), SVC (service), CAS (adjustment), and PLB (provider balance), with exception flags being reviewed by a specialist.
All line items are posted at the CPT/HCPCS level, with the original CARC codes (CO-45, CO-97, CO-16, CO-22, PR-1, PR-2, PR-3, OA-23) and all RARC comments preserved. CPTs and HCPCS have been posted to three separate buckets; i.e., contractual adjustments, patient responsibility, and payer payments.
All contract-typical contractual obligations (COs) are written off as a non-billable adjustment. All patient responsibilities are reflected as A/R, and all other adjustments (OAs, PIs, CRs) are categorized accordingly in accordance with the G/L mapping provided by you.
If a primary remittance has any indication of a secondary insurance coverage, we keep patient responsibility, create a secondary claim with attached EOB, and send it for crossover processing. Patient responsibility will not be finalized until all insurance carriers have responded.
All batches will match to the penny: (ERA total = total of amounts posted + total of cash not posted/retained + total of exceptions). When a deposit doesn’t match, automated research is initiated. Exceptions are categorized by CARC type and financial risk for prioritized resolution.
All contract-typical contractual obligations (COs) are written off as a non-billable adjustment. All patient responsibilities are reflected as A/R, and all other adjustments (OAs, PIs, CRs) are categorized accordingly in accordance with the G/L mapping provided by you.
If a primary remittance has any indication of a secondary insurance coverage, we keep patient responsibility, create a secondary claim with attached EOB, and send it for crossover processing. Patient responsibility will not be finalized until all insurance carriers have responded.
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Streamline coding, claims, and payment posting while staying compliant with podiatry-specific billing requirements. Discover how MedCare MSO helps your practice save time and collect faster.
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Purpose-built coding rules, compliance logic, and claim validation for every common podiatric procedure and treatment type.
More than most ambulatory specialties, podiatry policy denials are commonly compliance related such as the Medicare routine foot care modifier requirements, the frequency limitations on debridement of nails and the documentation requirements for DME. MedCare MSO's automatic coding of podiatry uses specialty-specific rules as codes are entered, prior to the claim submission. Modifier logic, bundling checks and Medicare compliance rules are run automatically and errors are caught internally, not on a remittance weeks later.
For a specialty like podiatry, manual billing is especially cumbersome, as many cases involve chronic care, which requires continuing documentation and billing coordination that generic tools simply don't get. Our podiatry billing software records charges from EHR documentation, verifies patient eligibility, posts the ERA, generates patient statements and manages denials allowing your billing team to focus on patient service and more involved payer escalations, instead of repetitive administrative work.
Podiatry practices that move to a podiatry billing system designed for the specialty generally experience a reduction in their A/R days and an increase in their collection rates in the first 90 days of implementation. These benefits combine to accelerate revenue from the delivery of service to collected payment, which helps practices achieve better cash flow and is easier for administrators to forecast monthly revenue.
The platform integrates with your podiatry EHR and practice management system to automate charge capture, claim validation and submission. Prior to sending, claims are reviewed for adherence to rules of coding for podiatry, Medicare requirements, eligibility and prior authorizations. Automated ERA posting and reconciliation, patient statements and recurring treatment billing, and live dashboards for real-time provider, payer and procedure performance.
MedCare MSO is designed to interface with every major podiatry EHR and practice management system using the HL7, FHIR, X12 and secure REST API frameworks. There's no manual re-entry required into the billing queue, no migration of the system required, and clinical documentation, imaging records and treatment notes flow into the queue.
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