Checklists for Optimal Revenue Cycle Management

Pediatric Practice revenue cycle management results can be attributed to multiple stakeholders in the revenue cycle.   While the Physician Xpress Account Managers and medical billing team have a significant role on managing claims, follow-up and reporting, the actions of the front desk team and the pediatric providers have an impact on the revenue cycle…

COVID-19 Impact on Pediatric Practices: Update End of 3Q21

It has been about one and a half years since the COVID-19 pandemic started within the United States. The COVID-19 pandemic consequentially altered how pediatric practices engage with patients. While the changes were significant, pediatric practice leaders and owners learned how to optimize the situation. The wearing of masks and practice of social distancing throughout…

7 Reasons Why Pediatric Groups Switch to a Pediatric Specialty Medical Billing Company

Most independent pediatric practices receive the majority of the practice revenue from patients with either commercial or managed Medicaid insurance.  The payments to the practice are based on the fee schedule established between the insurance company and the Pediatric practice.   Due to their depth of training and experiences, pediatricians have strong clinical knowledge, knowledge…

Managing Payor Denials related to Supplemental CPT Codes associated with Well Visits at Pediatric Practices

The use of scoring tools in Pediatrics helps the Pediatrician or Pediatric provider in making a more informed assessment of the child.    While using a scoring tool is extra work for the pediatric provider, in many cases, the payer will reimburse for the associated scoring tools CPT codes when utilized for appropriate pediatric patient…

Additional Coding Considerations for Well Visits: 96110, 96127, 96160, 96161

96110 Developmental screening (e.g., developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument Guidance on when to use this code for Pediatric well visits:    Add this code for 18 and 24 month well visit when complete MCHAT Can also add this code if complete developmental screening scoring tool.…

Reduce Administrative Work and Increase Revenue: Hire a Top-Performing Pediatric Billing Company

Ken Dominy Independent pediatricians that are practice owners have many roles.  While a practice owner might have the skills to do all the roles in their practice, many of the roles are lower revenue roles, some that distract the practice owner from growing the practice.  A Key Performance Indicator for pediatric groups is the number…