PDQ Billing Services                                                                        "Our work is the presentation of our capabilities"
                                                                                                                                                                                     Edmund Gibbon
   Call Us in Longmeadow,  Massachusetts, at  (413) 567-2258  
   Call Us in Myrtle Beach,  South Carolina, at   (843) 443-4232
   Call Us Nationwide,  at                              (866) 936-6097
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Pediatrics Billing Service


Pediatrics practice medical billing is constantly evolving and almost on a daily basis. Medical bill payers are implementing new billing regulations or changing existing claims processing procedures regularly. To offset this burden, pediatrics physicians are outsourcing their medical billing solutions.

Essentially, while growing a practice, the staffing and computer requirements for managing day-to-day billing and coding workload compound, resulting in an almost exponential build up of administrative challenges. At the same time, office procedures break down because of the growing need to cut corners to handle the build up of admin challenges; all due to the growing billing and coding workload.

Billing for general pediatric services presents many challenges for billers due to the numerous and varied issues of the young patient. The staff at PDQ Billing Services has many years of experience in responding to these sometime varied and complicated issues that can affect cash flow for the single or multi-office pediatric practice.

Here are just a few examples:

  1. Is the child’s insurance coverage subject to the “birthday rule” of the parents?
  2. Are the parents divorced but the non caregiver has financial responsibility?
  3. Was the visit for a well check, with different yearly deductible, vs. a sick visit?
  4. Are certain immunizations/procedures billed to a different insurance due to “carve outs” within an HMO plan?
  5. Are there special state or county plans that supply free medications to the Pediatrician but require special billing forms to pay for administration services? In California there is the CHDP (Child Health and Disability Prevention) with county variances.
  6. Is part of the patient volume covered under a capitated contract the physician has with the local IPA thus requiring special tracking and reporting of this data?
  7. Are computer generated reminder messages to parents (either by home phone, cell phone, or text message) needed to fill your appointment schedule for annual physicals, flu vaccines, or appointment reminder?
  8. Does the practice offer “urgent care” or “after hours” services and bill accordingly?
  9. Adding lab work to the visit is both convenient and beneficial to the practice. We have experience in billing lab panels to the health plans and explaining to parents any amounts not covered by the plan.
  10. How are “no shows” or short notice “cancellations” being addressed by the practice?

                                                           

 

                                                                          

                        

              


Contact us
in Myrtle Beach, SC or Longmeadow, MA 
for more information about our medical billing services.