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…
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…
While most of the 2022 No Surprise act is related to surprises patient’s receive in emergency care, some parts of the act apply to outpatient care. The emergency services situations include a fairly common situation like when a patient visits a local ER (for which hospital is in network) and receives treatment from ER…
The US government approved the CARES Act in April 2020. Part of the initial CARES Act was to provide funds to Health and Human Services for distribution to hospitals and providers for financial relief due to the COVID19 pandemic. HHS created a Provider Relief Fund via the Health Resources and Services Administration (HRSA) Provider Relief…
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…
Clinically Integrated Networks or the acronym, CINs, are quality focused organizations that negotiate with payers to provide potential additional payments to providers based on established criteria. This criteria is usually a shared savings based criteria or a HEDIS-based quality improvement metric. A CIN can be one Health System or a Health System and independent practices…
It has been over sixteen months since the COVID-19 pandemic started in the United States. The COVID-19 pandemic significantly 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 social distancing in the winter of 2020-2021 helped…
There are many learnings from the COVID-19 pandemic related to operating a pediatric practice. One key learning is that the COVID pandemic further confirmed that the core visit role of a pediatric office is the well visit and pediatric vaccinations. Pediatric practice leaders and owners should become even more focused on scheduling well visits for…
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