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Billing Archives - Office Practicum

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Very few things about medical billing are straightforward, but it’s especially true in pediatrics. Proper coding, modifiers, and changes in Medicaid rules and payer guidelines can turn a simple office visit into a minefield of dependencies. Add staffing shortages and the challenge of finding qualified medical billers to the mix, and it further exacerbates the stress of billing for pediatric practices. When it comes to running a pediatric practice, the days of “one size fits all” are over. You can no longer thrive and work efficiently using a generic, non-specialty-specific EHR, and the same is true for billing and revenue cycle...

If a pediatric practice has some extra down time, pause and remember the financial health of your practice starts with having an appropriate fee schedule. While contractually the payers determine how much they are going to pay you for each service you provide, it starts with how much you charge.  Scheduled Processes and Procedures At a minimum, at the beginning of the year, your practice should have a scheduled process and procedure for updating your fee schedule so you can be sure you are not leaving money on the table (and in the insurance company’s pocket.) The AAP has resources for pediatricians...

As a pediatrician, your primary goal is to deliver the best possible healthcare to your patients. Just as it's important for your patients to have regular check-ups as part of their wellness, it's also critical to regularly evaluate your pediatric office's financial health. But how? There are some key analytics that you can consistently examine to stay on top of your practice's financial well-being, while successfully planning for the future.  Whether your billing is done in-house or outsourced, here are 3 data analytics you should always have included in your monthly and yearly billing reports. 1. Number of Days in Accounts Receivable (A/R) You...

You’ve decided you’re ready to spread your entrepreneurial wings. You're going to open your own pediatric practice. While it’s an exciting time, it’s also busy with planning. You’ve got a checklist full of items like credentialing providers with payers, securing financing, choosing a location, purchasing technology, hiring staff, ordering supplies and furniture, and preparing forms and processes. Another important area to tackle before officially launching your new practice? Billing. It's one of the most critical elements of your business. Without a good billing system, you won't get paid appropriately. And a practice that's not profitable will quickly fold in the ever-changing world...

A frazzled mom walks into your pediatric clinic. She approaches the check-in desk, and your receptionist notices dark circles below wet eyes, red from crying, possibly even during the drive to the office.  The screaming toddler on the mom’s hip is not so interested in disguising his anguish. He wails in pain as he tugs on his ear, not afraid to let the tears fall freely. Even those staff members behind the check-in desk, standing at the hallway scale, or walking a patient to an exam room can hear the little guy. After checking in the fidgety little boy, the receptionist sees...

If your payment data is currently dispersed across multiple systems, you might hit a roadblock in your plan for payment assurance. What does your roadmap for payment assurance look like? Use these three checkpoints to analyze where your data might be failing you and how you can improve collection processes by pulling payment data from one reliable source. Checkpoint #1: Talk to Your Staff About Their Processes to Collect Collecting patient payments is time-consuming. Do you know how much time your staff spends to collect a single payment? Ask your staff to walk you through their daily process to collect, reconcile and post...

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