Bringing Balance to Podiatry Billing: Overcoming Common Hurdles with Confidence

In podiatric practices—whether solo, small group or mid-size – providing high-quality care is the top priority. But delivering that care while navigating a complex and ever-changing billing landscape can be demanding, especially as administrative pressures grow.

Billing is more than just submitting claims. It’s staying current on coding updates, preventing errors, managing rejections and denials, following up on unpaid claims and maintaining compliance with payer-specific policies. In a field like podiatry, where documentation and coding nuances – such as diagnosis specificity, modifiers and frequency limitations – can have a major impact on reimbursement, the billing process becomes even more demanding. But there is good news! There are ways to lighten the load and improve results – whether by tweaking your in-house process or turning to a trusted partner.

Let’s explore some of the most common billing challenges podiatrists face and how thoughtful operational changes can offer relief – even for smaller practices.

1. Time and Team Bandwidth

For many podiatrists, billing tasks eat into valuable clinical or personal time. Whether it’s chasing down missing documentation, investigating denied claims or updating knowledge of policy changes, billing can feel like a full-time job of its own.

 Even with a small in-house team, administrative burnout is real. And when billing staff are stretched thin, errors and delays become more likely. This can slow down cash flow, increase the risk of compliance issues and impact the patient experience.

2. Denials, Underpayments and Missed Revenue

Podiatry billing often involves procedures that are closely scrutinized by payers – routine foot care, nail debridement and orthotic services, to name a few. Missing documentation, incorrect coding or failure to meet medical necessity criteria can all lead to denied claims.

What’s more, some payers require frequent resubmissions or appeals, adding layers of work just to secure appropriate payment. Without specialized knowledge and a proactive process for handling denials, significant revenue can slip through the cracks.

3. Staying Ahead of the Curve

Insurance rules and coding guidelines are always shifting. CPT and ICD-10 updates, changes to Medicare guidelines and new prior authorization rules can all shift without much warning. Podiatrists especially those without full-time billing experts – may struggle to stay ahead of these changes.

Mistakes, even unintentional ones, can lead to audit risks, payment delays or missed revenue opportunities. And when payers update policies or implement new claim edits, it can take valuable time to adjust internal workflows.

4. Gains from Thinking Outside the (Billing) Box

For many small and mid-size practices, the idea of outsourcing billing may feel like a luxury reserved for larger groups. But today’s outsourcing options are built to support practices of all sizes – with flexible service models that adapt to your needs and budget.

Outsourcing doesn't mean giving up control. Rather, it means gaining a partner who specializes in navigating the billing landscape so your team can focus on care. With the right support, podiatrists can:

  • Reduce claim errors and denials through expert coding and pre-submission review

  • Accelerate reimbursement cycles with faster, cleaner claims

  • Improve insight into performance with clear, transparent reporting

  • Scale operations without hiring additional in-house billing staff

  • Reduce overhead and tech costs by leveraging the partner’s billing platform 

If you explore the idea, look for a partner with proven experience in podiatry billing. Ask about their understanding of the specialty’s unique challenges, how they handle denials, how often they communicate with clients and whether their approach can integrate with your existing systems.

5. Strategies if Keeping it In-House

Not every practice is ready to outsource – and that’s okay. If you’re keeping billing in-house, there are still proactive steps you can take to improve efficiency and performance:

  • Invest in training. Make sure billing staff receive regular updates on podiatry-specific coding and payer rules. A single training session can pay for itself in avoided denials.

  • Audit regularly. Even quick internal audits of a sample of claims can reveal patterns in documentation gaps or common errors.

  • Use technology wisely. Leverage your practice management system to track denials, monitor

  • A/R and generate reports. Templates and checklists for documentation can also help speed up claim prep.

  • Create a denial management workflow. Have a clear, repeatable process in place for tracking, correcting, and appealing denials – and designate someone responsible for overseeing it.

  • Stay connected. Join professional forums or organizations where billing trends and payer updates are shared – often in real time.

With the right systems and support – even in-house – practices can run more smoothly, reduce stress and improve financial outcomes.

Billing is one of the most critical pieces of your practice’s financial health—and one of the most complex. But complexity doesn’t have to mean chaos. Whether you choose to strengthen your in-house process or bring in outside support, taking steps to improve billing workflow, reduce denials and boost reimbursement is always a wise investment.

Podiatrists work hard to deliver exceptional care. With the right billing strategy in place, your revenue cycle can support that mission.

David Swiercz