Are documenting/submitting phone consultations and/or secure message exchanges worth the time and effort needed to appropriately do so? Many consultants may come up with ideas on how to enhance practice revenue without taking into consideration if the work required of the pediatric providers is worth the results, whereas a pediatric practice owner/administrator is more prone…
The selection of the appropriate E&M code is dependent upon time and/or complexity. This article provides an analysis on the addition of appropriate sick visit codes (e.g. 99212-99215) for when a child is present for a well visit. The determination of adding a sick visit code during a well visit is decided per the provider’s…
A monthly report should provide data associated with Key Performance Indicators for operating a pediatric practice. Some of the Key Performance Indicators (KPIs) to monitor via the monthly report include: Average AR Days: Average Accounts Receivable (AR) is a measure of, on average, how fast the practice is being compensated for services performed. The lower…
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…
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…
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…
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…
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.…
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…
Ken Dominy Accounts Receivable days, or more commonly known as AR days, is an important Key Performance Indicator (KPI) for revenue management at a pediatric practice. Since claims are sent to insurance companies and patient payments, there will always be pending revenue to be paid or Accounts Receivable (AR). AR Days is a calculation to…
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