Pediatric offices need for their staffs to be especially attentive to patients so outsourcing pediatric medical billing services can be particularly beneficial. Not only are there unique challenges to dealing with children, there are often siblings present and since children are so vulnerable to contagious diseases, extra precautions and short wait times are necessary, all of which require the attention of in-office staff.

Outsourcing medical coding and billing is especially helpful in a busy office where the staff has to be on their toes to ensure patients are treated as efficiently as possible. They have enough on their minds without having to be figuring out payer changes on the fly.

Medical Billing Is a Challenge for Pediatric Practices

Whether you are in an independent practice or part of a hospital or other larger institution, there are aspects of the field which make medical billing difficult.

Managing Seasonal Services:

Vaccinations are required more in pediatrics than any other specialization and careful coding to assure accurate record keeping is essential. Keeping track of which vaccines have been administered and which are required for school versus which are recommended for health purposes—and helping parents stay informed—are also important services of pediatric practices.

Compliance with Government Requirements for Offers and Incentives

The US government is typically more sensitive to assuring medical care is received by children and youth than adults, so more programs are available and recommended for pediatric populations. It is extremely difficult for a busy office staff to keep up with making sure all the requirements are followed to document participation so that the office can receive any remuneration it deserves from these programs.

Age Documentation Changes at Age 18:

As youth become adults, they will be transitioning to adult care, but many families will keep their children with their pediatrician through high school so coding and billing staff must be aware of CPT codes changing for everything when the patient turns 18, even though nothing else has changed in the patient’s life.

Handling Denials and Rejections:

Payers reject claims for the slightest errors or mismatched information. With families moving from place to place and changing pediatricians, it can be difficult to make sure the patient’s chart is fully up to date, but any mismatched information will trigger a rejection. Outsourcing the management of claims to a dedicated team of certified specialists is by far the best way to let the medical professionals focus on patient care while the billers make sure the practice is paid for the services it performs.

Medcare MSO’s Innovative Approach Optimizes Your Revenue Cycle Management

Outsourcing pediatric medical billing to Medcare MSO assures that your revenue is being managed by a team of certified specialists who are able to completely focus on that aspect of your business—allowing you to focus on taking care of patients. We have experience in over 40 specializations, including pediatric medicine, which means that we have billers who know what to look for and where any errors are likely to occur.

By having an understanding of what is covered, procedures that are performed together, and bundled billing charges, our staff can “scrub” claims prior to submitting them, assuring that only clean claims are sent to payers and when there are difficulties, they will be able to swiftly get them resolved.

Our services include everything required to optimize your revenue, including compliance reviews, annual payer adjustments, payer credentialing and more. Get a free demo today to see how we can save you work, while making you money.