• Revenue Cycle is the heart behind the Financial health of your Practice, never compromise on the people working on it

Pediatric Medical Billing

Partner with Wise Medical Billing (WMB) to increase total collections. In addition to the unique billing challenges pediatricians face, WMB understands the different state Medicaid requirements, vaccine administration, coding, combining well and sick visits during the same visit.

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Pediatric Billing and Challenges

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Burn out Front Desk Staff:
As pediatric practices deal with children, their in-house staff has more to do than those in other specialties. Since children are susceptible to contagious diseases and can be very restless, the front-office team needs to ensure a shorter waiting time. Additionally, they maintain vaccination records, age-change documents, and government compliance policies. It is necessary to hire specialized coding and billing personnel in order to prevent the compromise of patient care and ensure the accuracy of the billing process.
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Coding Issues:

There are several aspects associated with pediatric billing, such as meeting with parents and consulting medical records. For pediatricians to receive timely payment for everything they do, not just the obvious, they must have a thorough understanding of E&M codes.

Pediatricians must consider the time component when providing counselling and coordination of care, which can account for up to 50% of the time spent with patients and/or their families. The time spent with the patient that is not face-to-face can also play a crucial role in determining the level of coding, including the time spent reviewing records and tests, arranging for additional services with healthcare professionals, and coordinating care.
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Vaccines Administration:
The need for vaccinations is more essential in pediatrics than in any other area of medicine, and the use of pediatric billing codes to ensure accurate record keeping is essential. Pediatricians are also responsible for keeping track of vaccinations administered and which are required for school versus which are recommended for health reasons. They also keep parents informed about vaccines.
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Right Age Documentation:
In many families, children will remain with their pediatrician until they reach high school, so coding and billing staff must be aware that CPT codes will change for everything when the patient turns 18, regardless of whether anything else has changed in the patient's life.
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Denials and Rejections:
Even the slightest error or mismatch in information is enough to cause a payer to reject a claim. Changing pediatricians and moving from one location to another can make it difficult to ensure that the patient's chart is up-to-date, but any mismatch will result in a rejection. Medical professionals can focus on patient care by outsourcing the billing process to a dedicated team of certified specialists like wise medical billing while the billers ensure the practice is paid for its services.
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Compliance Issues:
In general, the US government is more concerned about ensuring that children and youth receive medical care than adults, so more programs are available and recommended for pediatric populations. A busy office staff may find it extremely difficult to follow all the requirements in order to receive any remuneration they deserve from these programs.

Benefits of Outsourcing Pediatric Billing to Wise Medical Billing

We take care of Everything:
As part of our Pediatric billing services, we handle patient scheduling, coding, and submitting claims. We also handle denials and rejections, compliance charting and coding, payer adjustments and paybacks, as well as bill collection. Due to our process effectiveness, clients tell us that our services increase their revenue so much that they do not consider them a cost.
Expert Pediatric Billing and Coding Team:
As medical billing guidelines continue to evolve under CMS/AMA/AAPC/ACA, our billing and coding professionals stay current to meet these challenges. Along with following up on unpaid or partially paid claims regularly, handling rejections, and appealing insurance denials in accordance with the billing guidelines, we pursue every dollar owed.
Expert AR Management:
As a company, we are proud of our ability to successfully pursue the difficult task of obtaining payment for old and aging claims for our clients. Our company believes that every single dollar our clients provide is worth every single cent. By utilizing WMB aggressive Account Receivable management system and a professional AR team, we pursue those old and aging claims our clients have lost hope of collecting.
Fast and Easy Access to Customer Support:
WMB recognizes the importance of prompt and easy communication between the billing company and the client. Our team of experienced and professional Customer Support representatives ensures that there is no lag in communication. You will be able to reach a dedicated Support representative by telephone, email, or text message at any time.
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1-(888) 816-6676
Wise Medical Billing expertise in Pediatrics includes but is not limited to:
  • General Pediatrics
  • Pediatric Endocrinology
  • Pediatric Diabetes
  • Pediatric Gastroenterology
  • Pediatric Cardiology
  • Pediatric Pulmonology
  • Pediatric Nephrology
  • Nutrition Services
  • Pediatric Infectious Diseases
  • Clinical Genetics
  • Behavioral Psychology
  • Pediatric Neurology
  • Pediatric Oncology
  • Child Life Program

Clients typically see an increase in revenue of over 20% and a reduction in denials of at least 15% as a result of our services. The application of our expertise and the rigor of our processes enables us to achieve this goal.

With Wise Medical Billing comprehensive end-to-end Medical Billing and Revenue Cycle Management Solutions for Pediatrics, you can reduce costs, improve efficiency, and generate more revenue.

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1-(888) 816-6676

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