What is pediatrics?
The American Academy of Pediatrics (AAP) has defined pediatrics as “the specialty of medical science concerned with children’s physical, mental, and social health from birth to young adulthood.
“Pediatric care encompasses a broad spectrum of health services ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases. Pediatrics is a discipline that deals with biological, social, and environmental influences on the developing child and with the impact of disease and dysfunction on development”.
Hence pediatricians deal with numerous conditions, procedures, treatments, and preventive healthcare. Pediatrics billing is a high-volume specialty, with pediatricians seeing 30-40 patients per day during the flu season. As the profit margins are thin, pediatric billing mistakes can cost the practice dearly.
An established and competent medical billing company can help a pediatrician submit error-free claims and have uninterrupted cash flow.
Billing for time spent
A pediatrician spends a considerable amount of time with the patient and the family of the patient. If time is considered a factor in the evaluation and management services, then documentation is essential. Documentation is the key to using time in determining the appropriate level of E/M code. The pediatrician should document all the time components and the summary of the items discussed during the visit. When documentation is robust, the physician can be assured of reimbursement.
Specific billing requirements
Pediatrics has its specific billing requirements. One critical component of pediatric care is the administration of vaccines. If vaccines are not billed or if billed and not followed up, a practice can lose a lot of money. It is vital that all the rules of the payor are followed without fail.
Staff education on payor rules
Errors frequently occur when coders are unaware of the billing rules that are being changed often. For claims to be passed the first time, staff education should be a regular feature in a billing company.
Not billing for services
Physicians may not be aware that they can bill for services they consider specialty (orthopedics), such as correcting an injury called Nursemaid’s Elbow. Likewise, a service such as the extraction of a foreign body can also be billed. These types of services can be charged at a higher rate. They are thus helping a practice increase its collections.
Pediatric practice can be challenging as dealing with children can be stressful. The front-end staffs have to handle many issues with patients and their families. Back office staff will have to ensure correct medical coding and medical billing to maintain the practice’s financial health.
How can Bristol Healthcare assist you?
Bristol Healthcare Services is here to take care of your pediatrics billing. Our experienced and knowledgeable billers will ensure that there are no billing and coding errors.
We have been serving healthcare professionals for more than 20 years. It is led by people who have decades of experience in this industry. The billers and coders are also experienced and their expertise is continually honed through staff education as the industry is seeing changes regularly.
Bristol Healthcare Services has invested in excellent human resources, hardware and software to render superior services to the medical fraternity. Our mission is to make sure that your claims are passed the first time and that your cash flow is uninterrupted.
Partner with us for a mutually rewarding venture!