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How Denial Reduction Impacts Monthly Revenue in Podiatry Practices

Michael Caputo

JARALL frequently hears from podiatry practices: "We're busy, but revenue still feels inconsistent." The root cause is often claim denials rather than insufficient patient volume.

Denials Are More Than an Administrative Problem

A denial means a service was rendered, documented, and billed — yet payment was withheld. Common causes in podiatry include:

Medical necessity issuesInsufficient documentation linking diagnosis to treatment

Frequency limitationsServices exceeding payer-specific visit caps

Incorrect or missing modifiersSmall coding errors that trigger automatic rejections

Incomplete documentationMissing progress notes or systemic condition records

Eligibility or authorization problemsCoverage gaps identified after service delivery

Each denial demands manual rework, and industry data shows **5–10% of denied claims are never recovered**.

The True Monthly Cost of Denials

Consider a typical scenario:

Monthly billing: $120,000

Denial rate: 10% → $12,000 denied

Unrecovered (7%): $840/month = $10,000+/year lost

Additional hidden costs compound the problem:

Staff time spent reworking claims

Delayed cash flow disrupting operations

Increased A/R days

Missed appeal deadlines resulting in permanent write-offs

How Denials Affect Cash Flow

Even recovered denials hurt revenue through delays:

Clean claims are typically paid in **14–30 days**

Denied claims often take **60–120+ days** to resolve

This disrupts payroll, vendor payments, equipment purchases, and growth decisions. The longer cash sits in limbo, the harder it becomes to plan ahead.

Why Podiatry Practices Are Especially Vulnerable

Payers scrutinize podiatry closely regarding:

Routine foot care vs. medical necessityA frequent denial trigger

Frequency limitsStrict caps on certain procedure codes

Modifier usagePodiatry-specific modifiers that general billers often miss

Supporting documentationHigher bar for proving medical necessity

Small errors trigger repeated denials without specialty-specific expertise.

Denial Reduction = Revenue Protection

Reducing denials produces immediate, measurable results:

1. Higher Net Collection Rate

More of what's contractually owed gets collected — without needing more patients.

2. Lower A/R Days

Fewer claims stuck in follow-up cycles means faster cash flow.

3. Reduced Administrative Burden

Staff redirects time from rework to patient support and practice operations.

4. More Predictable Monthly Revenue

Better planning, fewer surprises, and greater financial stability.

Even a **2–3% denial reduction** can mean **thousands of dollars monthly** for a typical podiatry practice.

How JARALL Reduces Denials

Our approach focuses on prevention rather than reaction:

Podiatry-specific coding and modifier accuracyBuilt from years of specialty experience

Documentation review for medical necessityCatching issues before claims are submitted

Payer-specific rule adherenceStaying current with each payer's unique requirements

Front-end eligibility and frequency checksPreventing avoidable denials at intake

Denial trend tracking and root-cause analysisIdentifying patterns to eliminate recurring issues

The emphasis is on **first-pass claim accuracy** — preventing denials before they occur rather than chasing them after the fact.

Final Thoughts

Denials quietly erode revenue, strain operations, and limit growth. Reducing them is among the fastest ways to improve financial performance without increasing patient volume. If your practice is busy but revenue feels flat, it may be time to look at what's happening after the patient leaves the office.

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