Frequently Asked Questions
Why do I need Rain City Foot Care?
Regular routine foot care reduces pain, reduces risk for falls, increases mobility and increases quality of life. Toe nails can grow out of control when left untreated, we are here to help. We do not replace your podiatrist, we compliment their services.
What Does Rain City Foot Care do?
Trim and thin nails using a combination of clippers and sanders, address and treat (within scope) ingrown toe nails, debriding callouses, assist with dry/cracked heals, and provide patient education.
Where does Rain City Foot Care go?
We are a mobile clinic, we come to you! We can come to homes, clinics, assisted living facilities, or adult family homes.
What forms of payment do you accept and what is the cost?
Cash, check, Venmo, Zelle, or credit card. Payment is due at time of service. Invoices can be sent if payment cannot be made at time of service. The first visit is $125 and ongoing visits are $100. There may be additional charges for prolonged visits due to high needs, or a second appointment may need to be made.
Do you accept insurance?
Routine foot care is not covered under insurance plans, so we are unable to bill insurance, however I can provide you with a Superbill for you to submit to your insurance company. Some clients report receiving a partial refund for services.
More about Medicare Reimbursement
The first question most people ask is, “Do you take insurance?”. While foot care nurses would love for Routine Foot Care (RFC) to be covered by insurance the frustrating truth is that it is not covered under any insurance plan. Routine Foot Care is defined as trimming, debulking nails, corns, and callouses. Insurance companies view RFC as a self-care activity, such as getting a hair cut. Foot Care Nurse’s, Patients, and Families know that RFC is a complex activity that requires specialized training and education to complete safely.
Does Medicaid ever pay?? Yes! But several conditions must be met. Medicare Part B covers foot care when several exceptions are met.
Medicare Part B will pay for foot care if the patient has:
- Mycotic (fungal) nails AND
- Diagnosis of a systemic conditions such as a metabolic disease such as diabetes, a neurologic condition such as peripheral neuropathy, toe deformity.
In the absence of system conditions:
- Ambulatory patients must have marked limitations of ambulation, pain, or secondary infection resulting from thickening and dystrophy (mis-shape)
of infected toenail plate.
- The non-ambulatory patient must suffer from pain or secondary infection resulting from the thickening and dystrophy of the infected toenail plate.
PLUS..
In the most system conditions, the patient is required to be under the active care of a physician. The active care requirement would be considered met if the claim indicates that the patient has seen the physician for treatment and/or evaluation of the complicating disease process during the 6 months before the routine foot care service.
Conclusion
Successful reimbursement for routine foot care services requires a detailed understanding of Medicare’s coverage policies, Local Coverage Determination, and specific treatment guidelines. Meticulous documentation, referring physicians, last patent visit dates, and specific billing codes must be adhered to diligently. In addition, commercial insurance policies may have additional requirements. Podiatrists themselves are moving away from providing routine foot care as a service due to the complex requirements for insurance reimbursement. Foot Care Nurse’s are small business owners and do not have the capacity to manage the arduous insurance requirements for reimbursement and often times, do not ever receive reimbursement from Medicare due to the many requirements, the claim is denied. Foot care nurse’s fill a valuable need in the healthcare world, using their years of training and expertise to care for patients individually, in their homes where they are most comfortable.