Pediatric RCM is all we do
Unlike generic billing services, OP RCM is focused solely on pediatric billing and financial performance. Our pediatric RCM team takes pride in having a seasoned skillset, making it easy for them to track discrepancies or changes in payer rules. Relaying this information back to your practice team ensures there is never a delay in cash flow.
The OP RCM team specializes in...
Nuanced and state-specific payer rules
With more than a third of US children on Medicaid, it’s critical that your RCM partner understands the nuances that come with billing state payers. Whether your patients have Medicaid or Commercial insurance, the OP RCM team understands what’s required for accurate claim payment. They’ve even developed their own playbook that details how to bill for Medicaid for every state where there is an OP RCM practice.
Vaccine billing
Whether you’re located in a universal vaccine billing state like Washington or Connecticut or a state that provides VFC (Vaccines for Children Program) and/or privately purchased vaccines, the OP RCM team ensures that vaccinations and the associated administration codes are billed properly. More than 50 percent of vaccine product for U.S. children is supplied by the VFC program, and the expertise of OP RCM’s billers ensures you receive maximum and appropriate reimbursement.
Reimbursements
While the average total dollar amount of a pediatric office visit claim is far less than that of another specialty like orthopedics or cardiology, your claims will get the full attention they require. The goal of the OP RCM team is to get you paid as much as possible for the services you provide as quickly as possible.
As of June 30, 2023, OP RCM managed over $225M
in annual charges.
Your financial results are our #1 priority
Our team’s pediatric-specific billing expertise — combined with proactive claim management — is the reason our pediatric RCM clients see:
Uninterrupted cash flow
We get your claims to payers without interruption for quicker payment turnaround.
Increased payment per visit
On average, our clients see a 7% increase in payment per visit.
Reduced write-offs
Our denial follow-up process ensures that you get paid for the services you provide.
OP RCM customers have averaged 26% growth supported by a 99% Net Collection Rate and Average Days in A/R < 30.
What a partnership with OP’s pediatric RCM service means
With OP RCM, you’re gaining a partner in profitability. Your financial results, backed by our understanding of KPIs, benchmarks, and performance improvement are our top priority. To this end, you’ll experience what we believe to be two of the most foundational components of a successful partnership— visibility and transparency.
With all claim activity occurring directly in your system and not a separate proprietary software that you can’t access, you’ll have complete visibility into your practice’s total performance. OP RCM’s billing experts take advantage of OP’s Advanced Workflow and Rules Engine (OP AWARE) and our fully integrated Claim Scrubber, a combination of technologies that ensures claims go out right the first time. And, using advanced reporting and dashboard tools within OP, you’ll be able to drill down into your practice’s billing data any time you want.
Our commitment to you
We’re not interested in just getting claims out the door. We’re committed to the financial success of your pediatric practice. By partnering with OP RCM, you’ll benefit from our Practice Optimization analysis to assess where you may be leaving money on the table. Our findings often lead to significant revenue increases. A recent analysis performed by the OP RCM team uncovered missed revenue in one 2-location practice that exceeded $17,000 over a two-month period, in part due to:
- Unbilled depression screenings totaling $6,000
- Value-add services conducted during well visits totaling more than $4,000
- Missed CPT codes totaling nearly $1,500
Are you confident that you’re optimizing billing for all of your services?
Don’t just take our word for it…
Check out our Client Success Stories to learn more about how a supportive pediatric RCM partnership with OP RCM can increase your practice revenue.
