Monitor and Measure Accounts Receivable Days to Identify Changes in Patient and Payor Payments

As discussed on a previous blog article a few years ago, Accounts Receivable Days is a key performance indicator to monitor.    Today, there was an interesting article in the Wall Street Journal that discusses the importance of monitoring the amount of Accounts Receivable in a business and that large businesses use a metric known…

Pediatric Provider Coding Review: ADHD Coding Example

In previous articles, we have provided a summary related to the selection of appropriate Evaluation and Management (E&M) codes (99202-99215) for a sick visit, or as an additional service provided during a well visit. The selection of said E&M code is a key component of pediatric office visits. While previous articles have described how to…

Managing Payer Edits to Achieve Optimal Reimbursements of Claims

Revenue Cycle Management of a pediatric practice is a team effort. Influences on pediatric revenue cycle performance include the front desk team members, medical assistants, providers, and the medical billing team. Previous blog articles include articles on the importance of each of these roles, and the potential impact they pose on practice revenue. The medical…

Phone Consultations vs. Secure Messaging Engagement with Patients

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…

Monthly Report Key Performance Indicators to Monitor

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…

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…