Suggested Process for Front Desk Team Members

The front desk team is a critical component of the revenue cycle management process. While the Physician Xpress Account Managers and revenue cycle management team are committed to optimizing the revenue cycle, we have learned over the years that the total collection rate is highly dependent on the consistency of the Pediatric Practice Front Desk…

Common Pediatric Coding Denials and Suggestions for Pediatric Practice Providers

Coding accuracy is critical for the financial health of any pediatric practice. All practices experience certain CPT codes that are bundled in with other codes and some level of claim denials. Understanding the most common pediatric coding denials—and how we minimize the impact on Pediatric Practices can help protect the bottom line and improve billing…

Striking the Balance Between Vision, Execution, and Collaboration in Pediatric Practice Operations

Running a pediatric practice is a team effort. At the heart of the operation is a partnership between the Physician Owner and the Practice Administrator — the duo responsible for both the clinical mission and the business engine. Note that in a small practice the Physician Owner might function as both the Practice Administrator and…

Roles of the Revenue Cycle Management Team Members – Front Desk, Provider, and Biller

In a pediatric practice, the Revenue Cycle Management (RCM) process is more than just billing—it’s a collaborative system that starts the moment a patient schedules an appointment and ends when the payment is received. Every team member plays a critical role, and understanding these roles is essential to improving cash flow, reducing denials, and enhancing…

Expectations of the Four Ps – Patients, Parents, Providers and Payers

In today’s evolving healthcare landscape, pediatric practice leaders and owners are finding themselves at the crossroads of multiple — and sometimes competing — expectations. To succeed and grow, it’s crucial to understand and balance the demands of the Four Ps: Patients, Parents, Providers, and Payers. Each brings unique expectations to the table, and meeting these…

Changes in Telehealth Coding for 2025: We are Ready…Are the Payers?

Since the COVID19 Pandemic started in 2020, the approach by payers related to telehealth has been fairly consistent and the CPT coding is the same CPT codes used for in person visits (e.g. 99212-99215). This is changing with 2025 since the Center for Medicare and Medicaid Services (CMS) provided an entirely new CPT coding approach.…

Common Pediatric Conditions During December and Year-End Holidays: A Guide for Pediatricians

The holiday season is a time of joy and celebration, but it also brings unique health challenges for children. As a pediatrician, you play a vital role in helping families navigate these common conditions and ensuring a healthy and happy holiday season for their little ones. In this blog, we’ll explore the most prevalent pediatric…

Optimizing Office Hours for Pediatric Practices in November: A Guide to Maximizing Efficiency and Patient Care

As a pediatric practice owner, you understand that November brings unique challenges and opportunities. Between flu season, school-related illnesses, and the holiday rush, patient demand can vary significantly. Scheduling your office hours effectively during this month is essential to balance your team’s efficiency with high-quality patient care. Here’s how to optimize your office hours during…

Maximize Your Year-End Quality Incentives: Focus on Well Visits Before December 31st

As we approach the end of the year, pediatric practices face a unique opportunity to boost both patient health outcomes and financial incentives. Quality Incentive Programs (QIPs) are increasingly tied to timely well-child visits, and the months leading up to December 31st are critical for meeting these benchmarks. Here’s how your pediatric practice can leverage…

Fall Vaccinations: Influenza Vaccine, RSV immunization and COVID-19 Vaccine

On August 26, 2024, the CDC published the respiratory vaccine codes and crosswalk tables for RSV, COVID-19, and influenza.  This article provides some background information and considerations related to the upcoming fall vaccination season for influenza, RSV and COVID-19.   Each Pediatric practice has choices related to their approach and management of these immunizations available…