How We Streamline Pediatric Billing for Your Practice
Our CPEDC-certified coders understand the complex nature of pediatric codes and their correct usage. They have acquired this mastery by meeting the billing and coding needs of general pediatric clinics, specialty pediatric centers (e.g., pediatric cardiology, oncology), urgent care pediatric hospitals, and school-based health clinics, among others. You can bank on them to leverage their expertise to reduce claims denials, enhance cash flow, and revamp your pediatric billing process end-to-end. Here is how we help you with our pediatric billing and coding services:
- Integrate digital tools like EMRs, EHRs, and EDI into your billing software to streamline electronic claims and payments.
- Collect and verify complete patient info and insurance details for accurate claims documentation.
- Determine and apply for pre-authorizations as needed for services rendered.
- Expert handling of various billing models, including value-based, capitation, telehealth, and school-based billing.
- Assign accurate codes including age-specific CPT, ICD-10-CM, and HCPCS codes (e.g., E1229-E1239).
- Follow up-to-date coding guidelines across pediatric specialties like neonatology, oncology, diabetes, etc.
- Adapt to fee schedule changes for payers including Medicare, Medicaid, CHIP, FEHBP, and private insurers.
- Review EOBs to identify discrepancies, resolve them, and manage appeals accordingly.
- Communicate payment responsibilities to patients after verifying deductibles, copays, and coinsurance to minimize unpaid claims.
