Medical Billing and Coding Pediatrics

Medical Billing and Coding Pediatrics

Pediatrics Medical Billing

Pediatrics is the branch of medicine that identifies & treats diseases in newborns, children & adolescents. Per the American Academy of Pediatrics, Medical Billing and Coding Pediatrics care refer to the care delivered for people up to 21. Pediatricians deal with different illnesses, procedures, treatments, and preventive healthcare.

Pediatric billing & coding is different from other disciplines as it requires the billers & coders to be mindful of elements such as immunizations. Careful coding must be undertaken for immunization data so that the practice is reimbursed accordingly. Pediatrics might be challenging due to its many modifiers & bundling needs.

Methodology regarding Handling Issues in Pediatrics Medical Billing

Medical billing in pediatrics involves a number of particular issues. Pediatricians must manage a wide variety of disorders, procedures, treatments, well-child care, and preventative health care using a diversified array of diagnostic and treatment methods. Additionally, the healthcare coverage landscape for children is highly complicated. Without correct coding and claim submission systems, managing your revenue cycle and guaranteeing maximum reimbursement is impossible. Outsource Strategies International (OSI) possesses the specific knowledge and resources necessary to provide doctors and pediatric practices with accurate and fast medical billing services. Our HIPAA-compliant services assist you in obtaining maximum compensation by ensuring that your claims are clean and require fewer re-files and/or appeals.

Individual physicians, multispecialty groups, clinics, free-standing diagnostic facilities, long-term care institutions, acute care facilities, hospitals, and ambulatory surgical centers all benefit from our medical billing company’s bespoke solutions.

The in-house personnel in pediatrics practices have more on their plates than other specialties, as dealing with youngsters can be hard. The front-office crew should ensure a reduced waiting period since children are susceptible to contagious infections and can be highly restless. They also keep vaccination records, age change documentation, and government compliance standards. Specialized coding and billing experts are essential to prevent compromising patient care and assuring accuracy in processing.

Whatever be the size of your pediatrics practice, outsourcing your billing & coding obligations to seasoned pediatrics billing service providers like Medical Billing Wholesalers will help you reduce money and pump new vigor into your revenue cycle. We offer prior authorizations, claim submission, accounts receivable, denials management, and credentialing services. Our team of pediatrics billing specialists can help construct a leakage-free revenue cycle for your practice.

The Advantages of Our Pediatric Coding and Billing Services

We provide competence, knowledge, and precision in pediatric billing and coding services while also ensuring that your practice’s revenue cycle is error-free. Our team works to ensure that the billing, coding, claim submission, and payment posting processes are as painless as possible. We follow up on accounts receivables persistently and obtain prior authorization to avoid claim denials. Our denials team is dedicated to refocusing your efforts away from denial management and toward denial prevention. Medical Billing Wholesalers assists pediatricians in concentrating their efforts on providing exceptional care to their small patients by focusing on administrative and financial excellence. We provide you with a team of specialists that includes the following:

  • Successfully collaborate with Medicare and have a thorough understanding of state-specific Medicaid policies
  • Cost-cutting experts dedicated to assisting you in achieving greater clinical and operational efficiency
  • Our clients often notice an increase in revenue of over 20% and a decrease in denials of at least 15%. This is accomplished through the application of our expertise and process rigorous.

Expertise

  • Serves all specialized fields, including cardiology, dentistry, orthopedics, and infectious diseases.
  • Understands how to bill for infants, well-child and sick child visits, nebulizer treatment, and other pediatric procedures.
  • Appropriate knowledge of ICD-9, ICD-10, CPT, and HCPCS codes
  • Maintains current knowledge of new regulations governing major insurance companies, including Medicare, Medicaid, and Workers’ Compensation.
  • Suggestions for pending or refused claims
  • Audits of charts to ensure the correctness of claims
  • Can bill claims use any advanced software suite?

Our Services

We offer comprehensive services ranging from patient enrollment to claim filing, patient billing, and receivables management

  • Enrollment and scheduling of patients
  • Verification of insurance
  • Authorizations for insurance
  • Coding
  • Payment posting and account reconciliation
  • Management of receivables
  • Management of denials of claims

The Fundamental Benefits

  • Reduce the number of days in A/R
  • Regular quality assurance checks
  • Status reports on a daily, weekly, and monthly basis
  • Meetings held on a weekly basis to discuss progress and review reports
  • TAT tailored to your specifications
  • There are no long-term annual contracts.
OB GYN Billing and Coding Services

OB GYN Billing and Coding Services

Obstetrics & Gynecology is a subspecialty of medicine that focuses on the care of women during pregnancy and childbirth, as well as the diagnosis and treatment of illnesses of the female reproductive organs. Additionally, it focuses on other aspects of women’s health, such as menopause, hormonal imbalances, contraception (birth control), and infertility.

An OB/GYN practice performs a variety of operations, including surgeries, pre-and postnatal care, and routine health checks for women.

Expertise in OB/GYN Billing & Coding Medical Billing Wholesalers

At Nixxe MBS, our client base spans all 50 states and includes a diverse spectrum of hospitals, physician offices (including OB/GYN clinics), and medical billing firms. Our team of OB/GYN billers and coders leverage their experience and knowledge gained from working with obstetricians and gynecologists for the purpose of increasing revenue and driving growth. Nixxembs coders are certified by the American Academy of Professional Coders in ICD-9/10, CPT, and HCPCS coding rules supplied by CMS and AMA (AAPC). Our billing and coding expertise in OB/GYN includes the following specialties:

  • Obstetrics and Gynecology
  • Endocrinology of the Reproductive System and Infertility
  • Uro-gynecology and Pelvic Reconstructive Surgery Gynecological Uro-gynecology and Pelvic Reconstructive Surgery
  • Laparoscopic Advanced Surgery
  • Planning a Family
  • Gynecology in Children and Adolescents
  • Gynecology in Menopause and Geriatrics

Adhering to industry standards for OB/GYN billing and coding services

At Nixxe MBS, we understand the difficulties that OB/GYN clinicians encounter, including rapidly changing policy requirements, ICD revisions, and the sensitive nature of your specialty. Our certified coders are capable of selecting appropriate codes based on operative reports from actual surgical cases. We are available to you 24 hours a day to help you avoid problems caused by erroneous modifier usage and to teach your in-house billing professional how to avoid them.

OB GYN Billing and Coding Services

OB GYN Billing and Coding Services

Our specialized billing and coding staff works to minimize claim denials while improving payouts. This is accomplished through the use of effective. Streamlined methods that reduce the amount of time required to accurately bill for Ob/Gyn services.

Our strategy is based on strict adherence to coding standards and best practices, as well as the use of modern technologies. The MBW team is committed to providing data-driven solutions that aid in the reduction of denials and the growth of revenue.

Pros of Using our Facilities

OB GYN practitioners see a large number of patients, some infrequently, such as for yearly checkups, and others on a continuing basis for prenatal care and postpartum care. This requires medical coders and billers to be proactive in processing numerous claims and to understand all the components of bundled claims in order to avoid over or under coding, which not only results in charging too much or too little, but also constitutes a violation of the law and can be disastrous for a practice.

  1. Coverage Is Extremely Diverse

Obstetrics and gynecology are two of the most frequently excluded or limited fields of medicine from insurance coverage. Many have elaborate regulations indicating which items are covered and which are not. This is something that should be clarified before the patient schedules. An appointment to avoid any unexpected costs being issued to them later.

  1. Numerous Facilities

A practitioner may visit the same patient in the clinic and in the hospital, necessitating meticulous coding for each. Billers must understand which procedures are billable in certain circumstances and ensure that everything is documented properly.

  1. Claims at the global level

Certain payers and insurers combine care provided during pregnancy and childbirth into a single claim, which means the practitioner must provide nine months of service before being paid, and each claim is for a significant value, making it critical that claims are not rejected or refused.

Why are we here?

Our obstetrics and gynecology billers and coders would initiate a follow-up on patient claims that have been pending for more than 18 days and optimize your current cycle to 21 to 25 days, depending on the type of insurance accepted by your clinics, using their accumulated knowledge of the following:

  • Coding accurately on the ICD 10 and CPT platforms
  • Printing and distributing paper and electronic bills
  • Pursuing unpaid and outstanding claims
  • Pre-authorization for approaching operations is being worked on.

Some Important Highlights of OB/GYN Coding and Billing Services

  1. J2675 (Injection, progesterone) is a frequently used HCPCS code in OB/GYN, generating significant money for physicians.
  2. Reimbursement for HCPCS codes G0101, Q0091 is permitted just once per year, except in cases of medical necessity.
  3. To be reimbursed for CPT code 59514 (Cesarean delivery alone). An assistant surgeon must be present, as this is a highly compensated and complicated procedure.