Pediatrics Billing
At EMRSIVE Medical Solutions, we understand that pediatric billing requires precision and attention to detail. Our expertise ensures your practice thrives while your young patients receive the best care.
- Accurate Claim Submissions: Ensure timely ICD-10, CPT, and HCPCS code submissions for correct reimbursements.
- Lower Denial Rates: Our proactive denial management reduces claim rejections and accelerates payments.
- Custom Reporting: Receive detailed insights into your A/R, payment cycles, and corrective actions for enhanced financial performance.
Pediatrics billing presents unique challenges, including managing age-specific services, frequent preventive care, and the high volume of vaccinations and screenings. At EMRSIVE Medical Solutions, we specialize in handling the intricacies of pediatrics billing, ensuring compliance and maximizing revenue for your practice.
Our team is adept at managing pediatric services across multiple payers and regulatory guidelines, giving you peace of mind that your billing is in expert hands. Whether it’s routine well-child visits, developmental screenings, or complex care for chronic conditions, we ensure that all services are billed accurately to optimize reimbursements.
According to the American Academy of Pediatrics, children typically have 6-7 well-child visits during their first year, and pediatricians administer numerous immunizations in accordance with CDC guidelines. Accurate billing of these services is essential for revenue cycle management, especially since pediatric practices often operate on tight margins.
We handle a wide range of pediatric services, ensuring precise coding and compliance with payer guidelines. Below are the most commonly handled services in pediatric practices:
- Diagnostic Codes: Used to report specific conditions, ensuring that appropriate coverage and payment are received. Pediatric-specific conditions can include routine child health exams or influenza with respiratory symptoms.
- Common Pediatric Services: We expertly manage billing for pediatric services such as:
- Office visits for established patients, scaled by the complexity of care.
- Vaccine administration, including counseling on vaccine benefits and side effects.
- Developmental screenings for conditions such as autism spectrum disorder or speech delay.
- Additional Services: Billing for injections, durable medical equipment, and other essential supplies like pain relief injections and flu vaccinations.
With the constant evolution of pediatric care guidelines and billing requirements, our team stays up to date with the latest coding standards and payer policies, ensuring compliance and reducing denials for pediatric claims.
Our seamless billing process ensures accurate coding, faster reimbursements, and reduced denials.
- Patient Registration: Capturing and verifying patient details to ensure smooth claim submission.
- Medical Coding: Applying accurate ICD-10 and CPT codes for diagnoses, treatments, and vaccinations.
- Claim Submission: Submitting claims to insurance for services rendered, following all compliance guidelines.
- A/R Management: Tracking outstanding payments and resolving aging accounts to minimize delays.
- Denial Management: Implementing corrective actions to resubmit denied claims and reduce the denial percentage.
- Reporting & Analysis: Delivering performance reports to optimize your financial strategy.
Pediatrics billing faces unique challenges, from frequent coding updates to complex regulations and age-specific requirements. Navigating through payer policies for services like vaccinations and developmental assessments can be time-consuming.
At EMRSIVE, we alleviate these burdens through:
- Up-to-date coding Knowledge: Staying current on ICD-10, CPT, and HCPCS code updates to ensure accurate claim submissions.
- Denial Prevention: Preemptive measures to reduce errors and improve first-pass claim approval rates.
- Fast Reimbursement: Our process reduces delays, helping you collect payments more quickly.
Outsourcing your pediatric billing to EMRSIVE provides peace of mind, with certified experts handling the intricate details of medical coding, reimbursement, and A/R. We offer:
- Certified Experts: Our team of credentialed professionals specializes in pediatric coding and billing compliance.
- Reduction in A/R & Denials: With our effective A/R and denial management strategies, we reduce claim rejections, ensuring a higher reimbursement rate.
- Tailored Reporting: We provide customized financial insights to help you optimize your billing processes and correct any issues that arise.
